Joint Aspirate

• Keywords:: Step 3 Rheumatology

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Joint aspiration

Joint aspiration findings can help narrow the differential diagnosis of joint pain. A synovial fluid leukocyte count of less than 2,000 cells/mL is seen in patients with noninflammatory conditions such as osteoarthritis. Leukocyte counts between 2,000 and 75,000 cells/mL are seen in inflammatory conditions like rheumatoid arthritis and

Medicine

• Keywords:: 000 Index
• Related: Step 3, Step 1, mksap, notes

Todos

• tolearn
• MKSAP todos
  • heart murmurs

Organ Systems

• Allergy and Immunology
• Rheumatology
• Cardiology
• Dermatology
• Endocrine
• ENT
• GI
• Hemeonc
• ID
• MSK
• Nephrology
• Urology
• Neurology
• Pulmonology
• Podiatry

Subject Areas

• General
• Biostats
• Psychiatry
• [[Geriatric

Ankylosing Spondylitis

• related: Rheumatology
• tags: #rheumatology

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Demographics

Ankylosing spondylitis is a chronic inflammatory disease affecting the axial skeleton, entheses, and peripheral joints. In contrast to other forms of spondyloarthritis, sacroiliac joint involvement is considered an essential feature of ankylosing spondylitis. Ankylosing spondylitis has a strong familial predilectio

gout

• related: Rheumatology

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• risks: obesity, alcohol, DM, men, aging
• premenopausal women don't have gout
• not every one with increased uric acid has gout
• hyperuricemia >7 for male, >6 for female
  • if > 10, risk increases to 30-50%
  • goal < 6 if diagnosed with gout

Pathogenesis

• pathogenesis: over producer or under excretor

  • can do 24 hour collection. > 800mg in urine = overproducer. <800 = underexcretor (90% of problem)

• stages:

  • asymptomatic

rheumatoid arthritis

• related: Rheumatology
• tags: #rheumatology

Pathophysiology and Risk Factors

• genetic risks:
  • 60% of risks
  • HLA class II most important, especially HLA-D
  • These HLA code for citrullinated peptide antigen that are immunogenic since citruline is not normally in humans
  • citrulline formed by peptidylarginine deiminase
• environmental: 40%
  • smoking activates PADI and citrullination, increases risk to 2-20x
• infection
  • periodontal:_

Approach to the Patient with Rheumatologic Disease

• related: Rheumatology
• tags: #rheumatology

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Inflammatory Versus Noninflammatory Pain

The differentiation between inflammatory and noninflammatory signs and symptoms is central to the evaluation of patients with musculoskeletal pain. Autoimmune conditions typically present with inflammation, whereas mechanical or degenerative disorders are characteristically noninflammatory. The cardinal signs of inf

Crystal Arthropathies

• related: Rheumatology
• tags: #rheumatology

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Gout

Epidemiology

Gout is characterized by intermittent painful inflammatory joint attacks, in response to crystals formed as a consequence of excessive levels of uric acid (hyperuricemia). Gout is increasingly common, with a U.S. prevalence of approximately 4%. Factors contributing to this increase include dietary changes, increasing obesity, and an aging population (the elderly acc

Fibromyalgia

• related: Rheumatology
• tags: #rheumatology

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Epidemiology and Pathophysiology

Fibromyalgia is characterized by widespread pain, fatigue, disturbed sleep, and cognitive dysfunction. It is common (prevalence, 2%-3%), particularly among individuals of lower socioeconomic status and/or educational level. Prevalence increases with age, peaking around the seventh decade. The female-to-male ratio is approximately 3:1.

Early paradigms of fibromyalgia a

Infectious Arthritis

• related: Rheumatology
• tags: #rheumatology

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Diagnosis

Clinical Manifestations

Infectious arthritis typically presents with pain, swelling, warmth, and erythema of the affected joint, accompanied by fever and constitutional symptoms. Knee infection is common, but any joint may be affected. Previously damaged joints are at increased risk for involvement. Monoarthritis or new inflammation of a single joint in a patient wit

Inflammatory Myopathies

• related: Rheumatology
• tags: #rheumatology

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Overview

The inflammatory myopathies include polymyositis (PM), dermatomyositis (DM), immune-mediated necrotizing myopathy (IMNM), and inclusion body myositis (IBM). Although the pathogenesis of these disorders is disparate, they all include immune-mediated muscle inflammation and destruction.

Evaluation of the Patient with Muscle Pain or Weakness

The differential diagnosis of muscle d

Mixed Connective Tissue Disease

• related: Rheumatology
• tags: #rheumatology

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Overview

Despite long-standing attempts to define rheumatologic diseases according to precise classification, some patients express only nonspecific, nondiagnostic signs and symptoms (undifferentiated connective tissue disease UCTD), whereas others experience features of more than one disease simultaneously (overlap syndromes).