Continue our discussion of Rheumatology.
We'll take a look at rheumatic diseases.
Under rheumatic disease,
our category include
Now, the first example
that we're going to walk you through
is going to be osteoarthritis. But,
very importantly, you need to be
able to compare this with
So, how do we approach arthritis in general?
With joint pain is going to be
a common symptom,
except that doesn't tell you much.
Apart from the fact that, "Oh, yeah,
I have issues in the knee,"
Most likely, I'm going to go
with what most likely.
Also, we're going to pay
attention to those joints
that most likely will lead you into
the proper diagnosis.
What's the difference between
arthritis versus arthralgia?
Algia refers to pain,
whereas itis refers to well, inflammatory,
but even that
can be a little tricky, you shall see. But
technically speaking, there is a difference
in definition between the two.
Arthralgia, sensation of pain,
but understand that the pain oftentimes
is accompanied by
the arthritis, perhaps, maybe around
the joint or periarticular.
Next, we'll be defining what's meant
by acute and chronic,
especially, for example, we talk
about crystalline arthritis,
for example, gout.
We'll talk about acute and chronic gout
or talk about issues even with pseudo
gout, what that means.
So what are the common joints
that are to be affected?
Well, the small joints. That's a
big, big, big, big deal.
Small joints. What do you mean small
joints? Oh, maybe the fingers.
Those are really tiny, huh? I want you
to put out your hand for me.
Can you reach out? There you are.
Now, what I'm reaching out
for is going to be the DIP.
Picture that for me.
Distal interphalangeal joint. Huh.
So if in osteoarthritis DIP is affected,
technically, do you remember
what the name of that is?
If you've never seen it before,
then you have no idea,
but it's called Heberden nodes.
Heberden, DIP. Picture that.
What's a little bit proximal to it?
How about we call that PIP?
Ha ha. That's brilliant.
Proximal interphalangeal joint.
Those are called Bouchard's nodes, okay?
So those are 2 joints. Quite specific.
Usually going to be asymmetrical.
What else might be affected? Can you…thumb up?
Give me a thumbs up because you're
doing well. You're getting this down.
No. Seriously speaking,
that is your first digit.
Can you picture the carpometacarpal?
CMC stand for carpal.
What are your carpal bones?
Think, for example, the trapezium.
Can you picture the trapezium for me?
Now, that, plus your metacarpal is your joint.
Interesting enough, the thumb joint,
carpometacarpal phalangeal joint
be affected by osteoarthritis.
So what I'm trying to give to you
is the foundation of comparing
rheumatoid arthritis that we'll
discuss, moving forward.
Small joints: DIP, PIP, carpal metacarpal.
You're focusing upon the thumb,
the knees, as I told you. Obviously,
over a period of time, let's say the
patient is 45, 50, 55, whatnot.
As I stand here, I know I'm developing
I'm putting a lot of strain on my knees.
Hips, and maybe the spine.
At this point, give yourself a good example.
I told you the knee can be affected,
there are other joints as well.