– Relative Potency and Characteristics Steroids: – Articular Steroid Injection: – Peri-Operative Dosing (for patient on Steroids): – MSK changes associatted w/ Steroids: – Steroids: for Rheumatoid Arthritis: – when giving steroids for inflammatory arthritis, be sure that the arthritis is not due to a cryoglobinemia … Read more
– See: – Rheumatoid Arthritis – Steroids – Discussion: – corticosteroids may occassionally be used to alleviate intractable joint inflammation or vasculitis in RA; – however, there is a risk of iatrogenic Cushing’s syndrome; – intraarticular instillation of steroids is … Read more
– Stage I: – represents synovitis: – synovial membrane becomes hyperemic and edematous with foci of infiltrating small lymphocytes; – joint effussions w/ high cell count (5,000 to 60,000 per mm3) – x-rays will as yet show no destructive changes, but soft tissue swelling or osteoporosis may be … Read more
– See: Anti-Fungal Agents – Discussion: – is a fungus that may be introduced into the extremity thru abrasions caused by splinters or thorns (rose bushes); – incubation period is 1-12 weeks; – may start as a red papular lesion and then develops into an abscess and spreads to … Read more
– See: Occult Spondylolysis – Discussion: – spondylolysis is rarely symptomatic in adolescents; – in children, be especially concerned if symptoms that do not respond to rest or immobilization or if there are neurological findings. – diff dx: – disc-space infection … Read more
– See: Spondyloepiphyseal Dysplasia Congenita: – Discussion: – generalized skeletal dysplasia affecting primarily the spine & epiphyses of the larger, more proximally located joints; – many patients go unrecognized until the adolescent years when hip pain or scoliosis develops; – typically, patients develop hip pain and stiffness in the first or second decade and are … Read more
– See: Spondyloepiphyseal Dysplasia Tarda: – Discussion: – a type of short trunk disproportionate dwarfism, in which there is involvement of the vertebra and epiphyseal centers; – can be transmitted as autosomal dominant trait, although most cases arise as random mutations; – symptoms include delayed developmental milestones, diminished endurance, and … Read more
Discussion conditions include: AS Reiter’s Syndrome Psoriatic Arthritis Inflammatory Bowel Disease typically involves the axial skeleton; affected areas heal w/ fibroblastic proliferation followed by new bone formation; pathogenesis of these disorders is unknown except for Reiter’s syndrome, which is generally believed to result from aberrant host response to a pathogenic microorganism; Labs RF is negative; HLA-B27 phenotype: … Read more
– See: Pagets Disease – Discussion: – Paget’s disease involves spine, esp third and fourth lumbar vertebras, in up to 1/3 of affected patients, & lower thoracic vertebras in 20%; – most patients have symptoms; – localized pain can develop because of pathologic fracture w/ vertebral collapse, spinal-canal stenosis, … Read more
– See: Cervical Spine in Ankylosing Spondylitis – Clinical Findings: – loss of lumbar lordosis; – back motion is limited; – note that ability to lean forward has more to do with hip flexion than lumbar spine flexion; – w/ forward … Read more