CPPD is slightly more subacute in presentation.. When you wake up, muscles that have relaxed goes into spasm, and this causes pain in morning. Spinal Stenosis Pain remains in stopping and standing. Improves on sitting, and bending as spinal space is increased. Going upstair is better, but pain worse in going downstairs. Vascular Claudication Gets better at rest even while standing. Some arthritis do not have swelling. Like Viral arthritis, SLE. Distal muscle myopathy: Only IBM. All including metabolic myopathy, causes proximal weakness Inflammatory eye disease: Seronegative arthritis. ENT: Vasculitis: Elbow: Tophi,and Rheumatic Nodule .Some time wegners present with nodule. Fever in Rheumatology: AOSD, SLE Raynauds: Most important is to have pallor. Cyanosis is common, but if pallor is present, it is very suggestive. Hair Loss: Lupus. Rash: Lupus - Interdigital (between the rash); Dermatomyositis: Over the joint. Where to look for psoriasis Scalp, Peri-umblical area, Gluteal / Natal cleft, palms, sole, nail changes, knee externsor surface Lupus Peringo: around nose or ear (Sarcoidosis) Circinate balanitis: Reactive arthritis Keratoderma Blenorrhegicum: Reactive arthritits. Pyoderma gangrenous: IBD , Scar: Paper thin scar due to loss of subcutaneous bed Zagged boarders: Common in cryoglobinemic vasculitits. Nailfold Infarct: Rheumatoid Vasculitits. Eye: Uveitits:
Epi-scleritis: Red, usually not much pain, vision not affected. Acute Angle Closure Glaucoma: Emergency, needs to see opthal right away Rheum examination (look, feel, move) anatomy inflammation Function: Complication / stability of joint Antatomic position: 0 - 45 degree. except: Hand, and leg Move: Active, passive, stability, Marginal erosion: at the end of the cartilage, beginning of the bone. Seen in synovitis. Gout erosions Not always around the joint, but anywhere in the joint. So, they defy the rule of synovitis causing erosion. |
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