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16 Cards in this Set
- Front
- Back
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ACR Scleroderma Diagnostic Criteria
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Major Criteria
Thick, tight, indurated skin proximal to MCP or MTP Minor Criteria Sclerodactyly Digital pitting scars Loss of fat pad substance Bibasilar pulmonary infiltrates (The Major or 2 or more Minor) |
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What is it that kills in scleroderma?
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Fibrosis in the lungs is what kills them due to hypoxic disease
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Limited Systemic Sclerosis (lSSc)
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Thickening of fingers (± face and neck)
CREST Calicinosis, Raynaud’s, Esophageal dysmotility, Sclerodactly, Telangiectasias Late organ disease Anti–centromere Ab |
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Diffuse Systemic Sclerosis (dSSc)
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Raynaud’s (white, blue, red) within one year [. In raynaud’s the hands first turn white, then blue because it becomes ischemic and then red. This are the people who were gloves when it is only 55 outside and 3 pairs of socks.
Diffuse thick skin Interstitial lung disease Early organ disease Anti–Scl–70 |
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Diffuse Systemic Sclerosis Organ Involvement
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Gastrointestinal Disease
Lung Disease Kidney |
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Diffuse Systemic Sclerosis Gastrointestinal Disease
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Esophagus
Dysphagia, heartburn Colon Decreased peristalsis, diverticulae, bacterial overgrowth, diarrhea |
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Diffuse Systemic Sclerosis Lung Disease
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Interstitial lung disease
Pulmonary hypertension |
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Diffuse Systemic Sclerosis Kidney
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Renal failure
Secondary hypertension |
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Inflammation of the spine/SI joints and appendicular skeleton
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Spondyloarthropathy. Seronegative Spondyloarthropathy refers to : Test for rheumatoid factor and ANA (–)
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Features of Seronegative Spondyloarthropathies
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Axial spine involvement
Enthesopathy Asymmetric oligoarthritis Rheumatoid factor negative |
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Spondyloarthropathies with the highest association to HLA-B27
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ankylosing spondylitis. NOT a screening test
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Ankylosing Spondylitis presentation
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people who cannot bend their spine and they are young. The spine looks a bambu on Xray. Any movement of the spine causes pain and they are very stiff and articulation of the ribs so they cant take deep breaths. Constant exercise is recommended to loose them up the joints
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Ankylosing Spondylitis manifestations
ANKSPOND |
Aortic insufficiency
Neurologic: atlantoaxial dislocation, cauda equina syndrome Kidney disease from Secondary amyloid Spinal fracture, stenosis Pulmonary fibrosis Ocular: uveitis Nephropathy (IgA) Discitis |
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Ankylosing Spondylitis Tx
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NSAIDs, sulfasalazine (for peripheral arthritis), TNF inhibitors
Steroids are of no proven value Daily exercise |
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Ankylosing Spondylitis surgical
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Joint replacement
Vertebral wedge osteotomy Aortic valve replacement |
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Modified New York Criteria for Ankylosing Spondylitis
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1. Low back pain > 3 months, improved with exercise, not relieved by rest
2. Limitation of lumbar spine motion in sagittal and frontal planes 3. Chest expansion decreased 4. Bilateral sacroiliitis, grade 2–4 5. Unilateral sacroiliitis, grade 3–4 Definite AS if number 4 or 5 and any of 1,2,3 |
