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Flashcards in Rheumatology Deck (71)
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1

"tennis elbow"

lateral epicondylitis; MCC of elbow pain

2

sx. of tennis elbow

tenderness over lateral epicondyle
pain on resisted wrist extension and hand gripping

3

"golfers elbow"

medial epicondylitis

4

sx. of golfers elbow

tenderness over medial epicondyle
pain on wrist flexion

5

cubital tunnel syndrome

ulnar nerve entrapment
- pain and sensory/motor loss in ulnar region
-paresthesias in ulnar aspect of arm/hand

6

carpet layers elbow

olecranon bursitis
- extremely tender to palpation but does NOT cause restriction or pain with ROM of elbow

7

how can you diagnose trochanteric bursitis?

hip pain that pts can point to with one finger on lateral hip; pain worsened with actively resisted abduction

8

Tx. trochanteric bursitis

corticosteroid injection

9

what type of pain is consistent with hip joint pathology?

pain localized to groin and restricted ROM in hip

10

what kind of injury should make you suspect a meniscal tear?

twisting injury of foot in weight bearing position, in which a popping or tearing sensation is felt, followed by severe pain and swelling over several hours

11

sx. experienced by pts with meniscal tears

clicking or locking of knee secondary to loose cartilage; but usually pain only on walking, esp stairs

12

sensitive and specific tests to dx. meniscal tears

pain along joint line - sensitive
audible pop or snap in McMurray's test - specific

13

pain and tenderness over anteromedial aspect of lower leg just below the joint line of the knee; focal tenderness on the upper, inner tibia about 5 cm distal to medial articular line of the knee

anserine bursitis

14

young woman complains of pain in knee when going down steps and development of knee stiffness/pain at rest when knee is flexed for prolonged period of time

dx. patellofemoral pain syndrome

15

pt presents with pain when reaching overhead and when lying on their shoulder - dx?

rotator cuff tendinitis

16

rotator cuff tendinitis

inflammation of the supraspinatus and/or infraspinatus tendons as well as the subacromial bursa

17

adhesive capsulitis

frozen shoulder - decrease range of shoulder motion due to stiffness (not pain or weakness)

18

bicipital tendinitis

anterior shoulder pain is elicited with resisted forearm supination or elbow flexion

19

pt comes in with arm weakness, esp during abduction and/or external rotation

rotator cuff tear

20

how can you diagnose a rotator cuff tear?

positive drop-arm test (inability to smoothly lower affected arm from full abduction)

21

what is the next step in management of someone with referred shoulder pain?

CXR - helps identify underlying intrathoracic process (apical lung tumor, effusion,PTX)

22

how do you treat a pt with polymyalgia rheumatica who is having flares on steroid tapering?

give min. dose of steroids that prevents symptoms and add steroid-sparing agent such as Methotrexate

23

empiric therapy of choice for community acquired septic arthritis w/ synovial fluid positive for gram positive cocci

Vancomycin - increase in MRSA strains
- may switch to oxacillin or cefazolin once culture results are present

24

what is MRI of joints useful for?

detecting avascular necrosis
soft tissue masses
collections of fluid not visualized by other modalities

25

gold standard for diagnosing prosthetic joint infection

arthrocentesis with culture

26

CF in prosthetic joint infection

mostly pain
fever, leukocytosis absent
elevated ESR

27

pt who had arthroplasty many years ago presents with pain in proximal and medial aspect of the thigh that is worse with weight bearing

aseptic loosening

28

radiograph finding in aseptic loosening

osteolysis

29

what drugs can you use in an acute gout attack

NSAIDs - first line
corticosteroids
colchicine

30

when is colchicine most effective in tx. gout

pts with monoarticular involvement
when used w/in first 24 hours of attack can abort the attack