Flashcards in OA, Soft Tissue Disorders, and Vasculitis Deck (22):
What is carpal tunnel syndrome?
caused by entrapment of the median nerve
Symptoms in first 3 1/2 fingers
Numbness, tingling, weakness
Nocturnal awakening - shake
how do you diagnose carpal tunnel syndrome?
tinels or phalens
how do you treat carpal tunnel syndrome?
Treatable causes - repetitive injury, hypothyroidism, pregnancy, rheumatoid
Treatment - splint, NSAIDs, surgery
what is fibromyalgia?
Fibromyalgia is a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues.
how will the PE present for fibromyalgia? what about lab?
normal except for trigger points--> cause extreme pain
no lab changes present
What is the treatment for fibromyalgia?
Treatment – Aerobic exercise, relaxation, amitriptylline for chronic pain, pregabalin
If a joint looks red and angry, what should you do? what will the results tell you?
- synovial fluid analysis
Non-inflammatory - 200-2000
Inflammatory - 2000-50,000
Septic - 50,000-100,000
3. Culture & Sensitivity
what will give you a positive rheumatoid factor?
RA - 65-85% positive
Connective tissue diseases
Aging - 70 y/o (15%
What will give you a positive ANA?
Against nuclear cellular antigens
Found in many rheumatic disorders
Sensitive for SLE but not specific
SLE - 95%
Drug-induced SLE - 50%
Scleroderma - 75%+
RA - 25-50%
Sjogren’s - 50%
Dermatomyositis - 25%
Normal pop’n - 15%
what is anti-phospholipid syndrome?
Antiphospholipid syndrome occurs when your immune system mistakenly attacks some of the normal proteins in your blood. Antiphospholipid syndrome can cause blood clots to form within your arteries or veins. It can also cause pregnancy complications, such as miscarriage and stillbirth.
Antiphospholipid syndrome may cause blood clots to form in your leg veins, a condition known as deep vein thrombosis (DVT). Antiphospholipid syndrome may also cause blood clots to form in organs such as your kidneys or lungs. Damage depends on the extent and location of the clot. For instance, a clot in your brain can cause stroke.
There's no cure for antiphospholipid syndrome, but medications can be effective in reducing your risk of blood clots.
In antiphospholipid syndrome, your body mistakenly produces antibodies against proteins that bind phospholipids, a type of fat present in your blood that plays a key role in clotting (coagulation)
how do you diagnose anti-phopholipid syndrome?
one clinical and one lab must be found
Clinical (either of following) :
Vascular thrombosis – one or more episodes of arterial, venous, or small vessel thrombosis
Late term (>10 wk) abortion (normal fetus)
Premature birth (99%ile
-Lupus anticoagulant (prolonged PTT with failure to correct) x2 twelve weeks apart
Describe degenerative joint disease:
Age > 50
Female = male
<30 min stiffness
how can you help treat DJD?
Joint Protection / Weight loss
topicals --> capsacin
Joint injection--> corticosteroids, hyaluron
Orthopedic intervention--> Synoviectomy, joint replacement
what is first line for DJD
what is gout?
Acute, intermittent, inflammatory pauciarthritis - usually lower extremity
Crystals demonstrated in joint
MTP is most common joint
what is the treatment for gout?
Acute - oral colchicine, NSAIDs, or steroids
Chronic - uricosuric vs. xanthine oxidase inhibitor (allopurinol vs. febuxostat)
what are the seronegative Spondyloarthropathies?
there are four types:
1. Ankylosing Spondylitis
2. Reactive Arthritis
3. Psoriatic Arthritis
4. Inflammatory bowel disease
associated with hla-b27 (NOT diagnostic)
describe Ankylosing Spondylitis:
Bilateral sacroiliac involvement
spine begins to fuse together --> bamboo spine
Asymmetrical joint involvement
-Cardiac – aortic insuff, heart block
what are the two types of reactive arthritis?
-High male:female ratio
-Equal male:female ratio
what is psoriatric arthritis?
May involve SI joints
7% of patients with psoriasis
- may see nail pitting and nail infection
what are the types of arthritis associated with IBD?
Associated with either ulcerative colitis or Crohn’s disease
Two types – axial or peripheral
Peripheral type – fluctuates with underlying bowel disease