Major manifestations of rheumatologic diseases
JOINTSBones are linked by joints. There are three main subtypes. 1- Fibrous joints characterized by limited . movement like skull sutures
2- fibrocartilage joints These joints comprise a simple bridge of fibrous or fibrocartilage tissue joining two bones together where there is little requirement for movement. The intervertebral disc is a special type of fibrocartilage joint in which an amorphous area termed the nucleus pulpous lies in the centre of bridge.
3-Synovial joints Synovial joints are more complex structures containing several cell types and are found where a wide range of movement is required. Articular cartilage In synovial joints the bone ends are covered by articular cartilage. This is an avascular tissue consisting of chondrocytes embedded in a meshwork of type II collagen fibrils that extend through a hydrated 'gel' of proteoglycan molecules example the knee .joint
MAJOR SYMPTOMS IN JOINT DISORDERS
Pain Stiffness Joint swelling and deformity Functional impairments Systemic manifestations Extra-articular featuresIMPORTANT MSK SYMPTOMS
Pain Usage pain-worse on use, relieved by rest (mechanical strain, damage) example disc prolapse . Rest pain-worse after rest, improved by movement (inflammation).example rheumatoid arthritis. Night or 'bone' pain-mostly at movement (bone origin)STIFFNESS
Subjective feeling of inability to move freely after rest. Duration and severity or early morning and inactivity stiffness that can be 'worn off' suggest degree of inflammation . Example rheumatoid arthritis stiffness more than hour .*
Weakness Consider primary or secondary muscle abnormality Swelling (Fluid, soft tissue, bone) Deformity (Joint, bone)
JOINT REDNESS
Acute gout Acute septic arthritis Acute psoriatic arthritis Inflamed overlying skin*
ARTHRITIS SYMPTOMS
Arthritis causes joint pain, swelling, stiffness, and limited movement. Symptoms can include: Joint pain Joint swelling Reduced ability to move the joint Redness of the skin around a joint Stiffness, especially in the morning Warmth around a joint*
ARTHRALGIA
Arthralgia is pain in one or more of your joints. The pain may be described as sharp, dull, stabbing, burning or throbbing, and may range in intensity from mild to severe.ACUTE MONO-ARTHRITIS HISTORY
Septic arthritis Crystal synovitis Trauma Haemarthrosis Foreign body reactionPOLYARTHRITIS: SELECTED CAUSES
Rheumatoid arthritis juvenile rheumatoid arthritis , spondylarthropathies , systemic lupus and .* Rheumatoid Arthritis: Hands
Several months of disease
5 Years of Disease a very clear diagnosis