Study Notes on Rheumatology

Rheumatism or rheumatic disorders

Conditions causing chronic, often intermittent pain affecting the joints or connective tissue, encompassing at least 200 different conditions, including arthritis.

Raynaud's Phenomenon

A health condition in which the blood vessels in an individual's body narrow in response to cold and stress, leading to transient malperfusion of fingers, toes, nose, and ears.

Sequence of color change in Raynaud's Phenomenon

Initially white (lack of blood supply), then blue (absence of oxygen), and finally red (blood supply returns to normal).

Rheumatoid Arthritis (RA)

An autoimmune disease that causes chronic inflammation of the joints and can also affect other organs, referred to as a systemic illness.

Key symptom of RA stiffness

Most notable in the mornings and after inactivity.

Typical deformities in late-stage RA

"Boutonniere" deformity of the thumb and "Swan-neck" deformity of fingers, along with radial deviation of the hand and ulnar deviation of fingers.

Rheumatoid factor

IgM autoantibodies against IgG, positive in 70% of RA patients, used for prognostic rather than diagnostic purposes.

First-line drugs for RA

Aspirin and corticosteroids, used to reduce pain and inflammation.

DMARDs (Disease-Modifying Antirheumatic Drugs)

Second-line drugs like gold, methotrexate, hydroxychloroquine that promote disease remission and prevent joint destruction but are not anti-inflammatory.

Systemic Lupus Erythematosus (SLE)

An autoimmune disease characterized by periods of flares and remission, affecting various organs.

Characteristic rash of SLE

Butterfly-shaped (malar) rash across the nose and cheeks.

SLICC Classification Criteria for SLE

Require at least 4 criteria (1 clinical, 1 laboratory) OR biopsy-proven lupus nephritis with positive ANA or Anti-DNA.

Scleroderma / Systemic Sclerosis

A condition progressing from localized to systemic, characterized by collagen accumulation causing organ infarctions and rigidity.

CREST Syndrome

A limited form of scleroderma symptoms including Calci-Des deposits in skin, Raynaud’s phenomenon, Esophageal dysfunction, Sclerodactyly, and Telangiectasias.

Anti-centromere antibodies

Antibodies identified in 70% of patients with limited cutaneous scleroderma.

Dermatomyositis / Polymyositis

Conditions affecting proximal muscles, characterized by muscle weakness, pain, and fever, sometimes associated with malignancies.

Sjögren’s Syndrome

A chronic disorder leading to insufficient moisture production in certain glands, causing dry eyes (keratoconjunctivitis sicca) and dry mouth (xerostomia).

Vasculitis

An inflammatory vascular disease instigated by immunological reactions, impacting various organs.

Wegener Granulomatosis

A specific type of vasculitis characterized by granulomas, often starting in the upper respiratory tract before affecting systemic areas (pulmorenal syndrome).

Granuloma

A structure formed during inflammation, a collection of immune cells (macrophages), formed by the immune system to wall off substances perceived as foreign.

Giant Cell Arteritis

Common vasculitis in older women, presenting mainly as temporal arteritis, with symptoms like throbbing headaches in temples, eye pain, and a palpable painful hardened temporal artery.