-
Barlow's Disease
a) AKA
b) Caused by _________
a) Infantile Scurvy
b) Hypovitaminosis C
-
Forms collagen, osteoid, endothelial linings
Vitamin C
-
Scurvy:
a) Most common in what demographic?
b) Why in that demographic?
a) In babies 8-14 months
b) Fed pasteurized or boiled milk preparations
-
Latent period for Scurvy =
4 months
-
Diagnose:
- Cutaneous petechiae
- Bleeding gums
- Melena, hematuria
- Joint swelling
- Irritability
- Pain
- Frog-leg position
Scurvy
-
White Line of Frankel:
a) Describe
b) Associated with _____________
a) Dense zone of provisional calcification (WHITE LINE OF FRANKEL) – delayed conversion to bone.
b) Scurvy
-
Wimberger’s Sign:
a) Describe
b) Associated with ____________
a) Ring epiphysis
b) Scurvy
-
Corner (Angle) Sign:
Associated with what disease?
Scurvy
-
Pelkin's Spurs:
Associated with what disease?
Scurvy
-
Scorbutic zone (Trummerfeld’s zone):
Associated with which disease?
Scurvy
-
Subperiosteal hemorrhage:
Associated with what disease?
Scurvy
-
“Scorbutic rosary”
Associated with what disease?
Scurvy
-
Growth hormone is produced in the __________
Anterior pituitary gland
-
Define: Acral
Acral: pertaining to or affecting a limb or other extremity.
-
Activates bone growth
Growth hormone
-
Diagnose:
- Thick skin…heel pad
- Skull / facial changes
- Large hands, tufts
- ADI
Acromegaly
-
What condition is responsible for release of excessive osteoclastic hormone - PTH?
Hyperparathyroidism
-
Most common cause of Primary Hypercalcemia?
Hyperparathyroidism (Parathyroid adenoma)
-
Most common cause of Secondary Hyperparathyroidism (HPT)
Complication of renal disease
(Constant loss of Ca and P….stimulate Parathormone release)
-
Most common cause of Tertiary Hyperparathyroidism (HPT)
Dialysis patient
-
Diagnose:
- Female, 30-50 years of age (3:1)
- Weakness, lethargy, polydipsia, polyuria
- Calculus formation in kidneys
Hyperparathyroidism (HPT)
-
What causes the following symptoms:
- Stimulates osteoclastic resorption
- Ca and P accumulates in blood
- Phosphorus - more readily excreted than calcium
Hyperparathyroidism (HPT)
-
What will cause hypercalcemia and hypophosphatemia?
Hyperparathyroidism (HPT)
-
Subperiosteal bone resorption of the outer cortex at the ligament and tendon insertion points indicates____________
Hyperparathyroidism (HPT)
-
Describe: Brown Tumors
- - Osteoclastic giant cells
- - Cyst-like destructive bone lesions
-
Subperiosteal resorption of the radial margins of the middle and proximal phalanges indicates _______________
Hyperparathyroidism (HPT)
-
Subperiosteal resorption of second and third digits of the hand indicates ________________
Hyperparathyroidism (HPT)
-
Subperiosteal resorption of medial metaphysis of the humerus and tibia indicates _________________
Hyperparathyroidism (HPT)
-
Subperiosteal resorption of undersurface of the distal clavicle indicates _______________
Hyperparathyroidism (HPT)
-
Subperiosteal resorption of trochanters and tuberosities indicates __________________.
Hyperparathyroidism (HPT)
-
Diagnose radiographic findings:
Outer cortical erosion
- Irregular, frayed
- Lace-like appearance of external surface of bone
Hyperparathyroidism (HPT)
-
Diagnose radiographic findings:
Subarticular bone resorption
- Widened joint space
- Osteolysis
- AC joint, symphysis pubis, SI joints
Hyperparathyroidism (HPT)
-
Diagnose radiographic findings:
Salt and pepper skull/pepper-pot skull
Hyperparathyroidism (HPT)
-
Diagnose radiographic finding:
Accentuated trabecular pattern of remaining trabeculae
Hyperparathyroidism (HPT)
-
Diagnose radiographic findings:
- Loss of cortical definition
- Subligamentous bone resorption
Hyperparathyroidism (HPT)
-
Diagnose radiographic finding:
- Soft tissue calcification
Hyperparathyroidism (HPT)
-
Chondrocalcinosis is associated with _____________
Hyperparathyroidism (HPT)
-
List 5 common sites for radiographic findings of hyperparathyroidism.
- 1) Hands
- 2) Skull
- 3) Spine – rugger-jersey spine
- 4) Pelvis
- 5) Shoulders
-
Rugger Jersey Spine is associated with ____________
Hyperparathyroidism (HPT)
-
Osteolysis is associated with ______________
Hyperparathyroidism (HPT)
-
Hypocalcemia is associated with _____________
Hypoparathyroidism
-
Hyperphosphatemia is associated with ____________
Hypoparathyroidism
-
Diagnose radiographic finding:
- Calvarial thickening (thick skull)
Hypoparathyroidism
-
Diagnose radiographic finding:
- Hypoplastic dentition (dental abnormalities)
Hypoparathyroidism
-
Diagnose radiographic finding:
- Basal ganglia calcification
Hypoparathyroidism
-
Osteoblastic metastatic disease can cause _____________
Osteosclerosis
-
Paget’s disease can cause _________
Osteosclerosis
-
Sickle cell anemia can cause _______________
Osteosclerosis
-
Involves an end-organ resistance to Parathormone action.
Pseudohypoparathyroidism (PHP)
-
If parathormone is actually elevated, not lowered/absent, it indicates ____________.
Pseudohypoparathyroidism (PHP)
-
Dwarfism, obesity, round face, brachydactyly are all indicators of ___________________.
Pseudohypoparathyroidism (PHP)
-
Define: Brachydactyly
Brachydactyly refers to shortening of the fingers or toes due to underdevelopment of the bones in the hands or feet.
-
Abnormal teeth, mental retardation, impaired taste and smell are all indicators of _____________
Pseudohypoparathyroidism (PHP)
-
Pseudohypoparathyroidism (PHP) is most common in:
Females
-
Hypocalcemia and hyperphosphetemia are indicative of ________________.
Pseudohypoparathyroidism (PHP)
-
A normocalcemic form of pseudoparathyroidism
Pseudopseudohypoparathyroidism
-
Pseudopseudohypoparathyroidism is most common in ___________________
a sibling of Pseudopseudohypoparathyroidism
-
A positive metacarpal sign indicates _______________.
Pseudopseudohypoparathyroidism
-
Describe a positive metacarpal sign.
Radiographic finding on a standard posteroanterior hand radiograph, regarded as positive if a line drawn tangential to the distal ends of the heads of the fourth and fifth metacarpals extends through the head of the third metacarpal. A positive metacarpal sign reflects shortening of the 4th metacarpal.
-
The type of joints between the:
- Cranial sutures
- Tibia / Fibula
- Radius / Ulna
Fibrous Joints
-
The Pubic Symphysis and Intervertebral Discs are what types of joints?
Cartilaginous
-
The SI joints, digits and knees are all examples of what type of joints?
Synovial
-
Provides lubrication and nutrition for the joint.
Synovial fluid
-
Articular cartilage in joints is a form of ______________ cartilage.
Hyaline cartilage
-
Found directly under the cartilage, this area has active tissue with abundant blood supply .
Subchondral bone plate
-
Name the 3 classifications for arthitic disorders
- 1) Inflammatory
- 2) Degenerative
- 3) Metabolic
-
Which is the only type of arthritis to present with Periostitis?
Inflammatory arthritis
-
Which is the only type of arthritis to present with Osteophytes?
Degenerative arthritis
-
Which is the only type of arthritis to present with poorly defined bone erosions?
Inflammatory arthritis
-
Which is the only type of arthritis to present with sharply defined bone erosions?
Metabolic arthritis
-
Which is the only type of arthritis to present with decreased bone density?
Inflammatory arthritis
-
Which is the only type of arthritis to present with [normal] or increased bone density?
Degenerative arthritis
-
Which is the only type of arthritis to present with normal joint alignment?
Metabolic arthritis
-
How many joints must be involved in arthritis for it to be considered "polyarticular"?
5 or more joints = polyarticular
-
Which is the only type of arthritis to be strictly polyarticular?
Inflammatory arthritis
-
Which is the only type of arthritis to be strictly monoarticular?
Degenerative arthritis is strictly monoarticular
-
Which is the only type of arthritis that can be either monoarticular or polyarticular?
Metabolic arthritis
-
Which is the only type of arthritis to be symmetrical?
Inflammatory arthritis
-
Term for the union of the bones of a joint by proliferation of bone cells, resulting in complete immobility.
Bony ankylosis
-
Which is the only type of arthritis to cause Juxta-articular osteoporosis?
Inflammatory arthritis
-
Rheumatoid arthritis is what type of arthritis?
Inflammatory arthritis
-
Psoriasis is what type of arthritis?
Inflammatory arthritis
-
Ankylosing spondylitis is what type of arthritis?
Inflammatory arthritis
-
Reiter’s syndrome is what type of arthritis?
Inflammatory arthritis
-
Subchondral cysts can be found with what type of arthritis?
Degenerative arthritis
-
Subchondral cysts AKA _________
Geodes
-
Non-uniform loss of joint space is an indication of what type of arthritis?
Degenerative arthritis
-
Subchondral sclerosis is an indication of what type of arthritis?
Degenerative arthritis
-
Periarticular soft tissue masses is an indication of what type of arthritis?
Metabolic arthritis
-
Well-marginated bone lesions is an indication of what type of arthritis?
Metabolic arthritis
-
Preservation of joint spaceis an indication of what type of arthritis?
Metabolic arthritis
-
Gout is an example of what type of arthritic disorder?
Metabolic arthritis
-
Degenerative Joint Disease (DJD) AKA
Osteoarthritis*
* Even though DJD is not an inflammatory condition.
-
What is the most common joint pathology?
Degenerative Joint Disease (DJD)
-
Degenerative Joint Disease (DJD) can typically be found in what anatomic locations?
- - Small joints of hands
- - Larger weight-bearing joints
-
Primary DJD:
a) Ratio of Women:Men?
b) Typical age range for women?
- a) Ratio of 10:1 Women to Men
- b) Typically occurs in women during 5th-6th decade
-
Cartilage is composed of what 2 major substances?
- 1) Collagen fibers
- 2) Proteoglycan (aka "ground substance")
-
A degenerative form of arthritis in which cartilage within joints gradually breaks down.
Osteoarthritis
-
How do geodes form?
They form when DJD causes cortical microfractures allowing synovial fluid to enter subarticular (subchondral) bone.
Geodes = subchondral cysts.
-
Increased capsular insertion stress and ligament traction can cause _____________.
Osteophyte formation
-
List the 8 radiographic findings for Degenerative Joint Disease (DJD.
- 1) Asymmetrical distribution
- 2) Subchondral schlerosis
- 3) Articular deformity
- 4) Non-uniform joint space loss
- 5) Joint subluxation
- 6) Subchondral cysts
- 7) Osteophytes
- 8) Intra-articular loose bodies
-
Typically, non-uniform loss of joint space occurs where?
At areas of greatest intra-articular stress.
-
Subchondral schlerosis AKA
Eburnation
-
What physical condition must be present in order for eburnation (subchondral schlerosis) to occur?
Decrease in joint space.
(Seen where there is the greatest loss of cartilage)
-
What can occur where there are focal areas of osteopenia within subarticular bone?
Geodes (subchondral cysts)
-
Diagnose:
- Ovoid geographic lucency
- 2-20mm in diameter
- Thin, sclerotic margin
- Next to degenerative joint surface
Geode (subchondral cyst)
-
Intra-articular loose bodies comprised of pieces of subchondral bone. AKA
Joint mice
-
Describe Synoviochondrometaplasia, and why it is different from intra-articular loose bodies (joint mice)
Synoviochondrometaplasia is metaplastic synovium that produces cartilaginous and osseous debris.
Joint mice are debris produced by DJD.
-
Most common site for joint mice / intra-articular debris.
Knee
-
Term for a deformity due to repetitive stress and:
◦ Trabecular remodeling
◦ Fracture
◦ Collapse
Articular deformity
-
List 4 conditions that can cause progressive deformation of articular surfaces:
- ◦ Vascular disturbances
- ◦ Necrosis
- ◦ Collapse
- ◦ Joint degeneration
-
Coxarthrosis and Malum coxae senilis are both AKA's for _____________________.
Hip DJD
-
Hip DJD can cause increased risk of _____________
Osteoporosis
-
List the 3 types of Hip DJD joint migration.
- 1) Superior (Waldenstrom sign)
- 2) Medial (protrusio acetabuli)
- 3) Axial (superomedial displacement)
-
Axial migration of the hip from DJD is typically seen in cases of ____________.
Rheumatoid arthritis or infection
-
a) Describe Waldenstrom Sign
b) How does it appear on CT?
a) Superior displacement of the hip due to DJD.
b) Superior migration appears as anterior migration on CT
-
a) Describe protrusio acetabuli
b) How does it appear on CT?
a) Medial displacement of the hip due to DJD.
b) Medial migration appears as posterior migration on CT
-
Term associated with DJD that presents the following:
◦ Thickening on medial side
◦ stress-related
◦ altered joint mechanics
Buttressing
-
a) List the 3 compartments of the knee.
b) Which is the most common site of DJD?
- 1) Medial
- 2) Lateral
- 3) Patellofemoral *Most Common Site*
-
List two radiographic findings indicative of DJD in the knee.
- 1) Sharpening of tibial eminences
- 2) Calcified loose bodies
-
Describe: Os fabella
Os fabella is a well-corticated bone density posterior to the lateral condyle of the left femur. It exists in the location of the lateral head of gastrocnemius tendon.
It is seen in approximately 10% of the population.
-
Name a radiographic finding indicative of
advanced patellofemoral degeneration.
Patellar Tooth Sign
-
a) Describe the condition and list symptoms associated with Chondromalacia patellae.
Cartilage softening with pain and crepitus in patellofemoral joint.
- - Anteromedial knee pain
- - Retropatellar pain with direct compression (knee slightly flexed)
- - Crepitus, buckling, locking, stiffness, swelling.
- - *Movie Sign*
- - Patella alta
b) Trauma, patellar dislocation, malalignment syndrome, cartilage vulnerability, occupation.
-
List 5 causes of Chondromalacia patellae.
- 1) Trauma
- 2) Patellar dislocation
- 3) Malalignment syndrome
- 4) Cartilage vulnerability
- 5) Occupation.
-
"Movie Sign" is associated with __________
Chondromalacia patellae
-
a) Describe "Q Angle"
b) Normal limits =
Q Angle is used to detect patellar malalignment
b) Normal angle = 15°-20°
-
Talar beak, Tarsal coalition, and Calcaneal “spurs” are all associated with ______________
DJD of the ankle and tarsal joints.
-
What is the most common site for DJD in the foot?
1st Metatarsophalangeal joint
-
Osteophytes and deformity (hallux valgus) are both associated with ___________________
DJD in the foot.
*Simulates signs of gout*
-
If DJD in glenohumeral joint, suspect ____________
Suspect previous trauma or cartilagenous disease
-
What is the most common site, specifically, for DJD of the shoulder?
Inferior aspect of the Acromio-clavicular (AC) joint
-
Degenerative tendonitis + calcification =
- HADD
- Hydroxyapatite Degenerative Disease
-
a) Most common site for HADD in the shoulder?
b) Second most common site for HADD in the shoulder?
a) 1st MC = Supraspinatus tendon at the insertion on greater tubersity.
b) 2nd MC = subacromial bursa, below acromion and above humeral head.
-
What is the most common site for DJD of the wrist?
1st metacarpal-trapezium joint.
-
List 4 radiographic findings associated with DJD of the wrist.
- 1) Radial displacement (subluxation) of the first metacarpal base
- 2) Sclerosis
- 3) Osteophytes
- 4) Loose bodies
-
List 3 predisposing conditions that can cause DJD of the wrist.
- Predisposing conditions:
- 1) Radial and scaphoid fractures
- 2) Ischemic necrosis – scaphoid and lunate
- 3) CPPD crystal deposition disease
-
Triangular fibrocartilage calcification in the wrist is indicative of _________________
DJD of the wrist
-
Describe Heberden’s nodes
DJD (clinically enlarged joints) in the DIPs
Heberden = DIPs
-
Describe Bourchard’s nodes
DJD (clinically enlarged joints) in the PIPs
Bourchard's = PIPs
-
Term for Calcifying tendinitis and bursitis
- HADD
- Hydroxyapatite Deposition Disease
-
What is the most common age range and gender for HADD?
Age Range: 40-70 yoa
Men = Women in occurence
-
Most common single joint for HADD
Shoulder
-
Most definitive for of diagnosis for HADD
X-Ray
-
Term for tendon calcification at insertion site.
- HADD
- Hydroxyapatite Deposition Disease
-
Diagnose:
- Ovoid calcifications on tendons
- Sharp margins
- Does not blend into cortex of adjacent bone
- HADD
- Hydroxyapatite Deposition Disease
-
List 3 common sites for HADD
(Hydroxyapatite Deposition Disease)
- 1) Shoulder rotator cuff
- 2) Hip
- 3) Upper Cervical spine
-
Diagnose: Produces gout-like symptoms
- CPPD
- C
alcium Pyrophosphate Dihydrate - crystal deposition disease
-
a) In what regions does CPPD commonly present?
b) Typical age Range for occurance?
a) Peripheral joints (Knees, wrists, hands, ankles, hips, elbows)
b) MC > 30 yoa
-
Term for Crystal deposition into cartilage
- CPPD
- Calcium Pyrophosphate Dihydrate
- crystal deposition disease
-
Diagnose:
- Hyaline cartilage appears thin, linear, parallel to articular cortex.
- Chondrocalcinosis
- (associated with CPPD)
- - Calcium Pyrophosphate Dihydrate crystal deposition disease
-
Diagnose:
Fibrocartilage appears thick, irregular, shaggy, with poorly defined margins.
- - CPPD
- - Calcium Pyrophosphate Dihydrate
- - crystal deposition disease
-
Term for structural joint changes occurring due to CPPD crystals within a joint.
Pyrophosphate Arthropathy
-
Erosive Osteoarthritis AKA
Inflammatory OA
-
Diagnose:
- Episodic and acute inflammation of the DIP and PIP joints
- Bilateral
- Symmetric
Erosive Osteoarthritis (aka Inflammatory OA)
-
Diagnose:
- Middle-aged females
- Pain
- Edema
- Redness
- Nodules,
- Decreased ROM
Erosive Osteoarthritis (EO)
-
*** TRUE or FALSE:
CPPD can be found in the annulis fibers of vertebral discs.
*** TRUE
-
*** Psoriatic Arthritis has (a)____________-located erosions, versus Erosive Osteoarthritis (EOA) which has (b)__________ erosions.
(a) Psoriatic Arthritis = Peripheral erosions
(b) EOA = Central erisions (Gull wing Sign)
-
He-Bu-Ha:
Explain
- He = Heberden's Nodes = DIPs
- Bu = Buchard's Nodes = PIPs
- Ha = Hagarth's Nodes = MCPs
-
*** RA will NOT be found in the _________
DIPs
Distal Interphalangeal joints
-
** Describe: Terry Thomas Sign
Separation of scafoid and lunate bones
-
** "Spotty Carpal Sign" is associated with ___________.
Spotty Carpal Sign = Reumatoid Arthritis (RA)
* also seen in Gout
-
** Most common cause of bilateral protrusio acetabuli
Reumatoid Arthritis (RA)
-
- Describe: Psoriatic arthritis.
- What is it commonly associated with?
Psoriatic arthritis: – Marginal erosions with adjacent periostitis.
Commonly associated with Eorosive Osteoarthritis
-
** Describe Caput Ulna Syndrome
Separation at the Radiaus / Ulna joint.
-
Diagnose:
- Bilateral, symmetrical
- Peripheral joint involvement
- Begin at IP and MCP joints
- Progresses proximally
- Pain, tenderness, stiffness, swelling
- “Jelling phenomenon”
Rheumatoid Arthithritis
-
Rheumatoid Arthritis is most commonly found in what demographic?
- Rheumatoid Arthritis:
- 20-60yoa
- Female, 3:1 (in 20-40 yoa group)
- 1:1 (>40 yoa)
-
"Jelling Phenomenon" is associated with what disease?
Rheumatoid Arthritis
-
Diagnose:
–Soft tissue swelling
–MCP joints
Haygarth's Nodes
-
Diagnose from Lab Values:
–↑ ESR and ↑ C-reactive protein
–Presence of rheumatoid factor (not specific for RA)
Rheumatoid Arthritis
-
Diagnose:
Felty's Syndrome presents RA with what additional symptoms?
Leukopenia
Splenomegaly
- - Leukopenia
- - Splenomegaly
-
- Describe: Pannus
- What is it associated with?
Synovial proliferation forms pannus.
Pannus = vascular tissue – spreads over intra-articular surface of bone and cartilage.
-
Most common (MC) sites for Rheumatoid Arthritis.
- (List 6)
- 1. Hand
- 2. Wrist
- 3. Foot
- 4. Knee
- 5. Hip
- 6. Cervical Spine
-
What part of the hand with Rheumatoid Arthritis NOT be found?
DIP joints.
-
List two locations in the hand where marginal erosions are caused by rheumatoid arthritis (RA).
- Radial margins of 2nd and 3rd metacarpal heads
– Radial margins of the distal and proximal ends of the proximal phalanges
-
– Boutonniere deformity
– Swan-neck deformity
– Digital ulnar deviation
– Carpal radial deviation
Are all associated with what disease?
Rheumatoid Arthritis
-
Formed by proliferating fibroblasts and inflammatory cells.
Pannus
-
Vascular connective (granulation) tissue
Pannus
-
Produces more enzymes that destroy nearby cartilage, aggravating the area and attracting more inflammatory cells, thereby perpetuating the process.
Pannus
-
Erosion of the ulnar styloid process indicates _________________.
Rheumatoid Arthritis (RA)
-
Term for:
- multiple marginal erosions throughout carpus.
- (also seen in gout, tuberculous arthritis and Sudeck’s atrophy).
Rheumatoid Arthritis
-
Define: Terry Thomas sign
Separation of the scaphoid and lunate bones of the hand.
-
Describe: Caput ulnae syndrome
(location, movement,
- - Diastasis at the radioulnar joint
- - Ulna moves dorsally
- - May have extensor tendon rupture
-
In 15% of patients, the [limb] is the initial site of involvement.
The foot
-
Diagnose these radiographic findings of the foot:
- soft tissue swelling
- marginal erosions
- juxta-articular osteoporosis
- uniform loss of joint space
- deformities
Rheumatoid Arthritis (RA)
-
TRUE OR FALSE
Rheumatoid Arthritis (RA) will cause marginal erosion on the medial surface of all the metatarsal heads.
FALSE
RA will cause marginal erosion on the medial surface of the 1st thru 4th metatarsal heads, and the lateral surface of the 5th metatarsal head.
-
Describe Lanois Deformity
- Digital fibular deviation* at MTP joints (except 5th digit)
* Flexion deformities, dislocations of the toes, and advanced joint destruction
-
Diagnose Hip Pathology:
- Bilateral and symmetrical
- Axial migration of femoral head
- Superior and medial
- Small femoral heads
- Decreased joint space
Rheumatoid Arthritis
-
Term for Acetabulum displaced medially
Protrusio acetabuli
-
What is the most common cause of bilateral protrusio acetabuli?
Rheumatoid Arthritis (RA)
-
What pathology causes superior hip migration?
DJD
-
List two pathologies that cause medial hip migration.
-
List two pathologies that cause axial hip migration.
- - Rheumatoid Arthritis
- - Infection
-
Lytic mets, multiple myeloma, and hyperparathyroidism will all present what radiographic finding on the shoulder?
- Pencil-like tapering of the distal clavicle
-
Diagnose:
- Synovial erosions at humeral head
- Early inflammatory rupture of the rotator cuff tendons
- Humeral head elevates
- Space between clavicle and humeral head is decreased
Rheumatoid Arthritis
-
"Fat Pad" Sign indicates:
Fat Pad Sign indicates Rheumatoid Arthritis (RA) of the elbow in 90% of cases.
-
- Describe "Supinator Notch" Sign.
- What does it indicate?
- "Supinator Notch" Sign:
- - Early erosion
- - Proximal elbow, opposing the neck of the adjacent radius.
Indicates: Rheumatoid Arthritis
-
Uniform bicompartmental loss of joint space in the knee indicates _______________.
Rheumatoid Arthritis
-
Asymptomatic erosions on superior margins of the 3rd, 4th and 5th posterior ribs indicates _____________.
Patient with long-term (>14 yrs) of Rheumatoid Arthritis
-
What is the most frequent systemic autoimmune inflammatory disease affecting children?
JRA - Juvenile Rheumatoid Arthritis
-
What is "Still’s Disease"?
Juvenile chronic arthritis.
(Seronegative)
-
What are the three types of Seronegative Chronic Arthritis – Still’s Disease?
- 1) Classic Systemic Disease (20%)
- 2) Polyarticular Disease (50%)
- 3) Pauciarticular-Monoarticular disease (30)
-
Diagnose:
- Fever
- Lymphadenopathy
- Hepatosplenomegaly
- Anemia
- Pale, erythematous rash over trunk, face and extremities – migratory
- Mild radiographic joint changes
Classic Systemic disease.
(A form of Seronegative Chronic Arthritis – Still’s Disease)
-
Diagnose:
- 2x MC in females
- Bilateral, symmetrical with pain and swelling at distal extremities and cervical spine
- Clinical presentation simulates rheumatic fever
- Chronic – “bird-like” appearance
- Frail, delicate features of limb and face
- Small, receded jaw
Polyarticular disease
(A form of Seronegative Chronic Arthritis – Still’s Disease)
-
Diagnose:
- 3x MC in females
- Larger joints MC
- MC monoarticular site –knee
- In monoarticular type – complicated with iridocyclitis (inflammation of the iris and ciliary body)
Pauciarticular-Monoarticular disease
(A form of Seronegative Chronic Arthritis – Still’s Disease)
-
Diagnose:
- MC in females
- 2nd to 4th decades
- Fever
- Malaise
- Anorexia
- weight loss
- Polyarthralgia
- skin rash
Systemic Lupus Erythemetosis (SLE)
* Rash affects face, neck, elbow, dorsum of hands. Butterfly Rash in 40% of patients.
-
Alopecia occurs in 20% of patients with ___________.
Systemic Lupus Erythemetosis (SLE)
-
Ulcerations of the oral mucosa occurs in 19% of patients with ___________.
Systemic Lupus Erythemetosis (SLE)
-
Pericarditis occurs in 19% of patients with ___________.
Systemic Lupus Erythemetosis (SLE)
-
What are the three classic signs of Sjogren's Syndrome?
- 1) Keratoconjunctivis sicca (dry eyes)
- 2) Xerostomia (dry mouth)
- 3) Rheumatoid arthritis
*only 2 of 3 needed for it to be considered Sjogren's Syndrome.
-
Parotid gland enlargement in 50% of patients indicates ______________.
Sjogren's Syndrome
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