Scope of Rheumatic Diseases 2

8/12/2019 Scope of Rheumatic Diseases 2

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RHEUMATIC DISEASES: PATTERN

AND SCOPE

Dr. Femi Adelowo, FMCP, FWACP,FACR,FRCP Edin FRCP LondProfessor of Medicine and Consultant Rheumatologist, LASUTH. Ikeja


2/19

INTRODUCTION

MISCONCEPTIONS

1. Arthritis is not one disease: more than 200 types or causes

2. Arthritis is not exclusive disease of elderly 3. Arthritis affects all age groups

4- Rheumatology is the specialty of Internal Medicine that

deals with diagnosis and management of all types of arthritis,as

well as systemic auto immune Connective Tissue Diseases

5. Arthritis affects hard tissue of joints and synovial membranewhile rheumatism(soft tissue,non articular) involves

capsule,tendon,ligaments,muscles.

Rheumatologist treats medically, Orthopaedic Surgeon treats

with surgery.They are both complimentary, as well as other

medical personnel-Physiotherapist,occupational

therapists,nutritionist,podiatrist etc


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CONTD

The word - Rheumatic derived from the

word Rheuma

In Broad usage - refers to diseases of the

joints

Arthritis and Rheumatism


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EXTENT OF ARTHRITIS

355 million people have different types ofarthritis world wide

By year 2025, degenerative joint diseaseswill be most common cause of physical

disability Socio economic impact of rheumatic

diseases on the rise


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CONTD

USA315 million physician visits per year

8 million hospital admissions per year

17 million people with activity limitation

Prevalence in a rural Nigeria community31%


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HEALTH IMPACT

. Decreased physical functioning

- Increased psychological distress

- Decreased social functioning

- Increased health care utilization

- Increased work disability


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CLASSIFICATION

1. DEGENERATIVE ARTHRITIS

Osteoarthritis Spondylosis- Cervical, Lumbar

2. CONNECTIVE TISSUE DISEASE(SYSTEMIC AUTO IMMUNE)

Systemic Lupus Erythematosus

Anti phospholipid syndromeScleroderma

Dermatomyositis/ Polymyositis (Inflammatory Myositis)


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CONTD

CHARACTERISTICS

1 Female preponderance

2. Overlap

3. Familiar clustering

4. Multisystemic

5. High acute phase proteinsESR, CRP

6. HLA typing

7. Serological Response to steroids and immunosuppressives


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CONTD

3. INFLAMMATORY ARTHRITIS

A. Rheumatoid Arthritis

Sjogrens Syndrome

B. SPONDYLO ARTHROPATHY

Ankylosing Spondylitis


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CONTD

Psoriatic arthropathy

Reiters disease

Inflammatory Bowel arthropathy

Undifferentiated


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CHARACTERISTICS

OF SPONDYLOARTHROPATHY

Male preponderance

Buttock pain - Sacroiliitis

Back pain associated with stiffness

Oligoarthropathylarge joints lower limbs

Association with urethritis and diarrhea

HLA B27 positive

Good response to NSAIDs


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CLASSIFICATION CONTD

JUVENILE CHRONIC(IDIOPATHIC

ARTHRITIS) Systemic

Pauciarticular

Polyarticular

Juvenile SLE

Juvenile Dermatomyositis


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CLASSIFICATION CONTD

4 INFECTIVE ARTHRITIS

All infective agents including TB.Staph,Strept,Gonococci

5. REACTIVE ARTHRITIS

Reiters Disease Rheumatic fever

Post streptococcal Arthritis


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CONTD

6.VASCULITIS(Pauci immune complexes)

Primary or Secondary

Systemic or Cutaneous Large vessel- Giant Cell arteritis, Takayasu

Medium vessel-Polyarteritis nodosa, BehcetsDisease, Kawasaki

Small vessel(AASV)- Wegeners Granulomatosis,Churg-Strauss, Microscopic Polyangiitis.

Secondary vasculitis- RA,SLE,HIV,HCV,HBVSyphilis,Drugs-(sulphonamides, ofloxacin),infectionsmeningococcus,Staph,


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CONTD

7.CRYSTAL

Gout Pseudogout

Cholesterol

8.BONE DISORDERS

Osteoporosis

Osteomalacia


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9.HYPERMOBILITY SYNDROME

Heritable EhlerDanlos Syndrome

Pseudoxanthoma Elasticum

Marfans Syndrome

Benign Hypermobility Syndrome


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CONTD

10. SOFT TISSUE RHEUMATISM

Bursitis Tendinitis

Enthesopathies

De Quervain tenosynovitis

Carpal Tunnel Syndrome Fibromyalgia Syndrome

Polymyalgia Rheumatica


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CONTD

11.REGIONAL PAIN SYNDROMES: Backache, Shoulderpain syndrome,neck pain

12 RHEUMATIC DISEASES ASSOCIATED WITH HIV/AIDS

Reiters Disease

Psoriatic arthropathies

Spondyloarthropathies

Rheumatoid Arthritis

13.Arthritis Associated with malignancies- Leukemia(ALL inchildren)


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THANK YOU

Documents

Scope of Rheumatic Diseases 2