how many rheumatoid diseases have been identified?
> 100
CRPS
- other names
- key symptom
- believed to be dysfunction of what?
- causalgia or reflex sympathetic dystrophy
- severe, continuous pain out of proportion to injury, worsens over time
- CNS or PNS dysfunction (or both)
CRPS 1
CRPS 2
- no underlying nerve injury
- known nerve injury
most common demographics for CRPS
young women
symptoms of CRPS
intense burning or hot pain, joint stiffness/inflammation, motor dysfunction, skin hypersensitivity, altered skin temp, changes in skin color/texture, changes in nail or hair growth
stage 1 CRPS
severe pain, muscle spasm, joint stiffness, excessive hair growth, skin color and temp changes
stage 2 CRPS
pain intensifies, swelling, decreased hair growth, nail changes, osteomalacia, hypotonia
stage 3 CRPS
changes to skin and bone become irreversible, intractable pain, atrophy, joint deformity
Juvenile Rheumatoid Arthritis
- onset
- etiology
- prior to age 16
- unknown, genetic vs. environmental factors?
3 types of JRA
- pauciarticular
- polyarticular
- systemic or still’s disease
- (40-50%) four or fewer joints affected, usually leg and jaw
- (30%) five or more joints affected- can be as many as 40
- inflammation outside the joints (pericarditis, pleuritis), usually with fever and rash
pauciarticular and polyarticular forms of JRA are associated with ______
iridocyclitis- asymptomatic, but can cause visual loss if untreated
JRA diagnosis
no single test, symptomatology and clinical findings
- RF and ANA may be + or -
- all forms cause growth probs and jt. deformity
symptoms for JRA
arthritis, fever, rash, fatigue, anemia, loss of appetite, irritability, reduced mobility
ankylosing spondylitis
- what is it
- males_females
- onset location
- process
- may affect
- inflammatory disease of the axial skeleton
- 3:1 males>females
- SI joint, with ascending pattern
- inflammation>erosion>healing= bony fusion on fibrous ligaments
- patellar tendon and plantar fascia
ankylosing spondylitis
- mild to mod _____
- back pain and _____
- accompanied by ______
- treatment focus
- flares and remissions
- morning stiffness
- fever, fatigue, anemia, weight loss
- pain relief, preservation of ROM, prevention/correction of deformity
Systemic Lupus Erythematosus (SLE)
Autoimmune connective tissue disorder most common in women of childbearing age (70-90%)
SLE diagnosis
based on clinical findings supported by laboratory results (+ANA)
SLE symptoms and associated disorders
photosensitive malar rash (butterfly rash), arthritis (usually symmetric polyarthritis), cortical and trabecular bone loss, anemia, leukopenia, thrombocytopenia, cardiopulm issues, nephropathy, neuropsychiatric disorders
SLE treatment
early identification, NSAIDs, corticosteroids, anti-malarials, methotrexate, immunosuppressants, HTN treatment
scleroderma
- what is it
- females/males
- common early features
- inflammation, degeneration, fibrosis of skin, vasculature, joints and tendons, muscle, GI tract, lung, heart and kidney
- females > males (4:1)
- swelling and cyanosis of fingers, raynaud’s, heartburn, myositis, arthritis
scleroderma treatment
- NSAIDs, immuno-suppressants, corticosteroids, anticoagulants, anti-hypertensives, etc.
- treatments are palliative
Reactive/infectious arthritis
- what is it?
- 80-90% are ____
- what type of microorganisms?
- infection of a joint by bacterial, fungal, or viral agents
- monoarticular, can be polyarticular
- gram positive aerobes
risk factors for reactive/infectious arthritis
known infection, old or young, presence of another systemic disease, recent invasive procedure, prosthetic joint, immunosuppression, IV drug use
Gout
- primarily affects
- elevated _____
- deposition of _____
- may result from
- men (4:1)
- uric acid levels
- monosodium urate (MSU) crystals
- diuretic or aspirin use, renal insufficiency, enzymatic abnormalities, alcoholism
