Ankylosing Spondylitis
Overview Definition Ankylosing spondylitis (AS) is a seronegative spondyloarthropathy characterized by chronic and indolent inflammation of the axial skeleton. Mnemonic To remember the seronegative arthropathies, use the mnemonic “PAIR.” Epidemiology Etiology Pathophysiology Proposed mechanism of inflammation Axioskeletal changes Clinical Presentation Articular manifestations Extra-articular manifestations Physical examination Diagnosis Physical examination tests Imaging Laboratory Tests Management and […]
Rheumatoid Arthritis
Epidemiology and Risk Factors Epidemiology Worldwide incidence: 3 per 10,000 people per year More prevalent in: Native Americans North America Northern Europe 2–3 times more common in women Peak age of presentation is 30–50-years-old. Risk factors The cause of rheumatoid arthritis (RA) is unknown, but several risk factors play a role. Genetic predisposition: 2–3 times […]
Systemic Lupus Erythematosus
Epidemiology and Etiology Epidemiology Prevalence in the United States: Overall: 20–150 per 100,000 Women: 100–400 per 100,000 Pediatric systemic lupus erythematosus (SLE): approximately 2.5 per 100,000 More prevalent in people of African American or Asian descent More common in urban areas 10 times more common in women than men (no gender preference in drug-induced lupus) […]
Osteoarthritis
Epidemiology and Etiology Epidemiology Classification and etiology Risk factors Pathophysiology Clinical Presentation Commonly affected joints Symptoms Physical exam Diagnosis Imaging Osteoarthritis is a clinical diagnosis that is confirmed with imaging. Supporting workup The following tests are not used for the diagnosis of OA, but are used to exclude other causes of arthritis. Management The goals of […]
Sjögren Syndrome
Overview Definition Sjögren syndrome (SS), also known as sicca syndrome, is a chronic autoimmune and inflammatory condition leading to decreased lacrimal and salivary gland function, resulting in dry eyes (xerophthalmia) and mouth (xerostomia). Epidemiology Etiology Primary SS: Secondary SS: Presents in association with another autoimmune disease: Pathophysiology The overall mechanism for SS is unclear: Clinical […]
Reactive Arthritis
Overview Definition Reactive arthritis (ReA) is an autoimmune, post-infectious, seronegative spondyloarthritis. Mnemonic The seronegative arthropathies can be remembered as “PAIR.” Epidemiology Etiology Clinical Presentation Articular manifestations Onset is acute, within 1–4 weeks of an inciting infection. Peripheral arthritis: Enthesopathy: Tendonitis and periostitis: Dactylitis: Sacroiliitis: Extra-articular manifestations Ocular: Genitourinary: Mucocutaneous: GI: Cardiac: Clinical triad This classic […]
Marfan Syndrome
Epidemiology and Genetics Epidemiology Genetics Clinical Presentation Musculoskeletal Cardiovascular Ocular Other manifestations Diagnosis Table: Systemic score for the revised Ghent criteria (a score ≥ 7 indicates major systemic involvement) Wrist and thumb sign 3 points (both) 1 point (1) Pectus carinatum deformity 2 points Pectus excavatum or chest asymmetry 1 point Hindfoot deformity 2 points […]
Giant Cell Arteritis
Overview Epidemiology Etiology Pathophysiology Giant cell arteritis (GCA) is caused by a complicated cascade of vascular inflammation, damage, and dysfunctional repair: Clinical Presentation Clinical manifestations Physical exam Diagnosis Diagnostic algorithm Diagnostic modalities Management Treatment options General measures Differential Diagnosis References
Psoriasis
Overview Epidemiology Relatively common in children and adults 0.5%–11% of people worldwide 1%–3% of people in the United States Can be seen at any age, but incidence peaks at the ages of 20–30 and 50–60 (median age is 28 years) ⅓ of patients have a first-degree relative with the disease. Seasonal variation: worse in winter than […]
Gout
Epidemiology and Etiology Epidemiology Etiology Risk factors that increase UA levels Mnemonic Drugs causing acute precipitation of gout: FACT F: Furosemide diuretics A: Aspirin/Alcohol C: Anti-Cancer drugs (e.g., cyclosporine) T: Thiazide diuretics Pathophysiology Clinical Presentation Gout flares Intercritical gout Upon resolution of an acute gout flare, patients enter an intercritical (between-flares) period. Tophaceous gout Associated […]