Ankylosing Spondylitis AS

-Is a chronic inflammatory diseas of the axial skeleton with variable involvement of peripheral joints / It many affects joints in the spine and the sacroiliac joint in the pelvis / The majority of Pts with AS exhibit the (HLA-B27) antigen and high levels of immunoglobulin A (IgA) in the blood

-Symptoms & Signs :

.chronic pain and stiffness (low back pain)

.entire spine

.sarcoliac joint

-Diagnosis :

.X-ray studies of the spine (which show characteristic spinal changes and sacrolitis - obliteration of the sacroiliac joints with ossification in the spinal ligaments ‘bamboo spine’)

+ HLA B27 is associated with :

.Ulcerative colitis

.Crohn's disease

.Ankylosing spondylitis

.Reiter's syndrome

Erythema Nodosum EN

-Causes :

.idiopathic (M.C)

.infections (TB,hepatitis C,streptococcal,mycoplasma pneumoniae,yersinia,EBV)

.sarcoidosis,autoimmune disorders (IBM,behcet disease)

.pregnancy

.medications (sulfonamide,oral contraceptive,bromides)

.Arthralgia

.Residual bruised appearance

.Ulceration

.Tenderness of lesions

.Leprosy

.Indomethacin

.RA (?)

Nail Clubbing

-Clubbing associated with :

.lung cancer

.complicated TB

.lung diseases

.hypoxia

.congenital cyanotic heart disease (most common cardiac cause)

.atrial myxoma

.malabsorption

.croh`ns disease

.ulcerative colitis

.cirrhosis

.hepatopulmonary syndrome

.hyperthyroidism

.familial and racial clubbing and pseudoclubbing

Carpal Tunnel Syndrome

-Is a medical condition in which the median nerve is compressed as it travels through the wrist at the carpal tunnel and causes pain, numbness and tingling, in the part of the hand that receives sensation from the median nerve.

-Causes :

.RA

.hypothyroidism

.pregnancy

.amyloidosis

.repetitive activities of the hand and wrist

.DM

.acromegaly (causes excessive growth hormones)

.obesity

**Septic Arthritis (pyogenic arthritis)

-Is the purulent invasion (PUS) of a joint by an infectious agent which produces arthritis

-M.C.C of infectious arthritis is gonorrhea (gonococcal arthritis)

-M.C.C of infectious arthritis in older Pts is staphylococcus aureus

+ Causes arthritis :

.Staphylococcus

.Tuberculosis

.Gonococcal infection

.Lyme disease

Polyarteritis Nodosa PAN

-Is a multisystem disease that may present with nonspecific complaints such as (fever,weight loss,malasiae,anorexia and abdominal pain).The disease can affect nearly any site in the body,except the lungs / Commoner in males / Mononeuritis multiplex , MI and hypertension may occur

-Diagnosis made by biopsy

-Treatment is consists of high doses of corticosteroids and immunosuppressive drugs (cyclophosphamide)

Osteoarthritis OA

-Is the most common joint disease in humans.The target tissue in OA is articular cartilage.OA,unlike RA,is not an inflammatory disease / M.C joint to be affected is the knee,the 2^nd M.C joint affected is the base of the thumb / in general,the major joints involved in OA are the weight-bearing joints (hip and knee) and the small joints of the fingers (PIPs & DIPs)

-Risk Factors :

.age

.female sex

.genetic factors

.major joint trauma

.repetive stress

.obesity

.gout

.endocrine disease (DM,acromegaly)

.deposition disease (hematochromatosis)

.exercise

-Laboratory tests :

.ESR and C-reactive protein (are always normal in OA)(if ESR is elevated,some other process is complicating OA,septic joints,or it`s not OA)

.X-ray findings (osteophytes and unequal joint space)

+Bouchard`s nodes (when changes occur in the PIPs)

+Heberden`s nodes (when changes occur in the DIPs)

-Diagnosis :

.clinical

.X-ray

-Treatment :

.NSAIDs

.COX-2 inhibitors (used in Pts who are at high risk for GI complications)

.orthopedic surgery and joint arthroplasty

Date: 2016-04-22; view: 590