14.02.19 Rheumatology revision
Rheumatoid Arthritis Associations
Eyes
Secondary Sjögren's syndrome
Scleritis
Episcleritis
Skin
Leg ulcers
Felty's syndrome
Rashes
Nail fold infarcts
Rheumatoid nodules
May occur in the eyes, may be subcutaneous, and may be in the lung, heart and occasionally the vocal cords
Neurological
Peripheral nerve entrapment
Atlanto-axial subluxation
Polyneuropathy
Mononeuritis multiplex
Respiratory
Pleural involvement
Pulmonary fibrosis
Bronchiolitis obliterans
Caplan's syndrome
Cardiovascular
Pericardial involvement
Valvulitis
Myocardial fibrosis
Vasculitis
MI
Kidneys
Analgesic nephropathy
Amyloidosis
Liver
Mild hepatomegaly
Abnormal transaminases
Other
Thyroid disorders
Osteoporosis
Depression
Splenomegaly
SICKFACES.COM Group
Sodium valproate
Isoniazid
Cimetidine
Ketoconazole
Fluconazole
Alcohol (acute)
Chloramphenicol
Erythromycin
Sulfonamides
Ciprofloxacin
Omeprazole
Metronidazole
Grapefruit juice
Seronegative arthropathies
Ankylosing spondylitis
Spinal movement reduced in all directions
Question-mark posture
Associations: All the A's:
Ankylosis of spine
Acute anterior uveitis
Amyloidosis
Aortic incompetence
Aortitis
AV Block
Apical fibrosis
Achilles tendonitis
Anti-TNF alpha therapy
Psoriatic arthritis
cf Arthritis mutilans
Reactive arthritis
Chlamydia is the most common trigger (50%)
Also Salmonella
Antibiotics don't help
Enteropathic arthritis
Felty's syndrome
Combination of rheumatoid arthritis, SPLENOMEGALY and neutropenia
Normally after a long time with RA
Manage by controlling the underlying RA
Pancytopenia with bone marrow hyperplasia
cf Hypoplasia as side-effect of medication
Notes
Eyes
Scleritis is PAINFUL
Episcleritis is PAINLESS
Keratitis is BILATERAL
Anti-TNF alpha
CHECK TB STATUS
Really good for ank. spond.
Steroids => Striae on trunk
Brick-shaped, positive birefringent crystals in pseudogout
SLE: ANA 95%, anti-dsDNA 80%
Schober's test