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Principles of Medicine (Prelim)

1
By:Leaño

RHEUMATIC stiffness, swelling, joint damage and loss of


function
AND GRANULOMATOUS • affects joint of the hands and feet
DISEASES • symmetrical

3. JUVENILE ARTHRITIS
RHEUMATIC DISEASES • most common form in childhood
• may be associated with rashes or fever
DEFINITION: • may affect various parts of the body
Painful conditions usually caused by • pain stiffness, swelling, loss of function
inflammation, swelling and pain in the joints or
muscles, including loss of function of one or 4. FIBROMYALGIA
more connecting or supporting structures of • chronic disorder
the body. • pain throughout the tissues that support and
move the bones and joints (muscles and
AREAS AFFECTED: joints, tendons, tendons)
ligaments, bones and muscles. • patients may also experience fatigue and
CAUSES: sleep disturbances
1. Genetic
2. Environmental EXAMPLES OF RHEUMATIC DISEASES
- excessive stress on the joint OSTEOARTHRITIS (OA)
- repeated injury • most common type
- infection e.g. virus: Eptein-Barr • affects both the cartilage and underlying
Virus and Lupus bone
3. Gender Factor / Hormonal Factor • there is damage to the cartilage (fraying and
- Lupus, RA, Scleroderma and wearing)
Fibromyalgia – more common • joint pain and stiffness
among women • disability results when the disease affect
WHO IS AFFECTED BY RHEUMATIC the spine and the weight bearing joints (knees
DISEASE? and hips)
- RA occurs 2-3x more often in women than
in men 5.SYSTEMIC LUPUS ERYTHEMATOSUS
-Scleroderma – more common in women (SLE)
-80 – 90% diagnosed with fibromyalgia are • autoimmune disease
women • results in inflammation of and damage of the
-Gout is more common in males than women; joints, skin, kidneys, heart, lungs, blood
after menopause, the incidence of gout for vessels and brain
women begins to rise
-SLE – more common in women 6.SCLERODERMA
• also known as systemic sclerosis
1. OSTEOARTHRITIS (OA) • “hard skin”: affects the skin, blood vessels
• most common type and joints; may also affect the lungs and
• affects both the cartilage and underlying kidneys
bone • abnormal and excessive production of
• there is damage to the cartilage (fraying and collagen in the skin and internal organs
wearing)
• joint pain and stiffness 7.SPONDYLOARTHROPATHY
• disability results when the disease affects • principally affects the spine
the spine and the weight bearing joints (knees
and hips) a) ankylosing spondylitis – affects people
in late adolescence or early childhood
2 .RHEUMATOID ARTHRITIS (RA) b) reactive arthritis –develops after an
•inflammatory disease of the immune system infection involving the lower urinary tract,
• targets first the synovium, resulting in pain,
Principles of Medicine (Prelim)
2
By:Leaño

bowel or other organs; commonly CAUSE: unknown


associated with eye problems, skin
rashes& mouth sores S/S:
8. INFECTIOUS ARTHRITIS • commonly, no symptoms and is often an
e.g. parvovirus arthritis gonococcal arthritis incidental finding in X-ray
• bone pain, deformity,fracture and arthritis
9. GOUT
• results from deposits of needle-like crystals • affects spines, femur, pelvis, skull, clavicle
of uric acid in the joints. and humerus
• episodic inflammation, swelling & pain in the
affected joint often the big toe 16. SJOGREN’S SYNDROME
• autoimmune
10. POLYMYALGIA RHEUMATICA • attacks glands that secrete fluid, such as
•involves tendons, muscles, ligaments and tear and salivary glands
tissues around the joint • inflammation within the glands reduces the
production of tears and saliva dry mouth and
11. POLYMYOSITIS dry eyes
•inflammation and weakness in the muscles
•may affect the whole body and cause CLASSIFICATION OF SJOGREN’S
disability SYNDROME

12. PSORIATIC ARTHRITIS PRIMARY – when the condition develops by


• occurs in patients with psoriasis (scaling skin itself
disorder) SECONDARY – when the condition develops
• affects the joints at the ends of the fingers in combination with another autoimmune
and toes accompanied by changes in the condition (lupus or RA)
fingernails and toenails. CAUSES: unknown
TRIGGERED BY: genetic
13. BURSITIS environmental
• inflammation of the bursae (small fluid – hormonal
filled sac that help reduce friction between WHO IS AFFECTED?
bones and other moving structures in the joint • common condition: 3-4% of adults in U.K.
• second most common autoimmune condition
14.TENDINITIS (TENDONITIS) after RA
• inflammation of tendons • most cases seen in ages 40-60 years old
• caused by overuse, injury or rheumatic • 90% of cases are women
condition
TREATMENT
15. PAGET’S DISEASE (OSTEITIS •eye and mouth dryness: artificial tears and
DEFORMANS) saliva
• chronic condition of bone characterized by • good eye and mouth hygiene to prevent
disorder of the normal bone remodeling corneal ulcers and tooth decay
process
17.TEMPOROMANDIBULAR JOINT
BONE REMODELING: normal bone can lay DISORDER(TMD)
down new bone and take up old bone • occur as a result of problems with the jaw,
- essential for normal Ca++ levels in our blood jaw joint and surrounding facial muscles that
control chewing and jaw movement
• bone remodeling is disturbed and not
synchronized: bone formed is abnormal, TMJ – the hinge that connects the lower
enlarged, not as dense, brittle and prone to jaw(mandible) to the temporal bone of the
fracture skull
Principles of Medicine (Prelim)
3
By:Leaño

CAUSE: unclear
POSSIBLE CAUSES:
• injury to the jaw, TMJ, muscles of the head
and neck
• grinding / clenching of the teeth
• dislocation of the soft cushion or disc
between the ball and socket
• osteoarthritis or RA in TMJ
• stress
S/S:
• pain or tenderness in the face, jaw joint area,
neck & shoulders, in or around the ear
• lock-jaw in the open or closed mouth
position
• clicking, popping or grating sounds when
opening or closing the mouth
• tired feeling in the face
• difficulty in chewing or sudden
uncomfortable bite
• swelling
• toothache, headache, neckaches,earache

TREATMENT

CONSERVATIVE TREATMENT
•apply moist heat or cold packs ice pack x 10
min. Do simple jaw stretching exercises Apply
a warm towel x 5 min.
• eat soft foods
• medications

NSAID – naproxen, ibuprofen


•anti-anxiety
• muscle relaxant

DIAGNOSIS:
History
P.E.: TMJ Examination
Panoramic X-Ray
MRI / CT scans

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