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9 Cards in this Set
- Front
- Back
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What acronym can you use for your pain hx?
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L-OPQRST AAA
(see week 4 objective 10 for more info) |
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What acronym may be useful in formulating hypotheses for your Ddx?
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MEDICINTIP
M = metabolic E = endocrine D = degenerative (OA) I = infectious C = congenital I = inflammatory/immune N = neoplasm (rare in joints) T = trauma I = idiopathic P = pregnancy |
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Why is joint distribution useful is formulating your differential dx?
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Some conditions have a predilection for certain joints. Some conditions are symmetrical or asymmetrical.
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What should be in your Ddx if you observe a monoarthritis?
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1. Crystal induced
2. Infectious 3. Systemic disease presenting with monoarticular involvement: -psoriatic arthritis -reactive arthritis -RA -SLE |
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What should be in your Ddx if you observe a symmetric polyarthritis?
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1. Inflammatory
A. infectious B. Post-infectious or reactive -Rheumatic fever -Post-strep arthritis C. RA D. Psoriatic arthritis E. Systemic rheumatic disease -SLE -Sjögren's -systemic Sclerosis (not CREST) -poly/dermatomyositis -MCTD -PMR -Systemic vasculitis 2. Non-inflammatory A. OA B. Crystal-induced -CPPD (pseudogout) (not gout) |
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What should be in your Ddx if you observe an asymmetric oligoarthritis?
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1. Inflammatory
A. Infectious B. Post-infectious/reactive C. IBD D. Psoriatic E. Systemic rheumatic disease -relapsing polychondritis -Behçet's disease -(not SLE, Sjögren's, sclerosis, poly/dermatomyositis, MCTD, PMR, systemic vasculitis!!!) F. Crystal-induced -GOUT -PSEUDOGOUT 2. Non-inflammatory A. OA B. CPPD (pseudogout) C. OA |
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What are important ROS questions to include?
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1. Cutaneous sx:
-nodules on elbows or extensor surfaces of arms (RA) - malar rash, photosensitivity rash, maculopapular rash (SLE) -leg ulcers/vasculitis (RA) 2. Mouth -ulcers (SLE) -dry mouth (RA, SLE) 3. Eyes -scleromalacia (RA) -keratoconjunctivitis sicca (RA, SLE) 4. Hair Alopecia (SLE) 5. Extremities Peripheral neuropathy (RA) Raynaud's 6. CNS sx (SLE) -seizures -psychosis 7. Kidney function (SLE) 8. Splenomegaly as part of Felty's syndrome (RA) 9. Sx of anemia (long-standing RA - ACD) (SLE-hemolytic anemia) 10. infections due to lymphocytopenia (SLE) |
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How does the temporality of symptoms aid in your Ddx?
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1. Prolonged morning stiffness (>1hr) consistent with inflammatory arthritis
2. Worse with rest, better with movement is consistent with inflammatory arthritis 3. Worse with movement, better with rest is consistent with non-inflammatory arthritis |
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Why is ROS essential?
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Many rheumatic conditions have extra-articular features that may aid in your Ddx.
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