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Rheumatic and Infectious Disease Emergencies- Karduck exam 3
Terms in this set (22)
Why does articular cartilage not produce pain?
no nerve endings
What is the synovial fluid like with synovitis?
thin, watery, contains inflammatory mediators
What are the clinical manifestations of synovitis?
boggy consistency of soft tissue over joint
What is enthesitis?
Inflammation at the transitional zone where collagenous structures such as ligaments and tendons are interwoven into bone
can also be between vertebrae in the annulus fibrosis
Where is the prinicipal site of pathology in the seronegative spondyloarthropathies?
When enthesitis is in a diarthrodial joint, what may develop?
What is the term for calcification of cartilaginous structures such as the meniscus seen in pseudogout?
What things MUST always be ordered on aspirated synovial fluid for gout?
fluid for crystals
If a pt has a hematogenous septic arthritis, what else must you assess for?
Look for endocarditis- auscultate for murmur and perform an echo
How long does it take for neutrophils to erode cartilage in infected joints?
What exposures should you ask about in the hx of a pt with joint pain?
ticks and STIs
What is the only confirmatory diagnostic study for joint pain?
What is the best indicator of RA?
What blood test is good for screening with joint pain?
Characteristics of normal synovial fluid
clear to pale yelow- transparent
WBC <200 and <25% PMNs
Characteristics of non-inflammatory (group I) fluid
pale yellow- transparent
WBC 200-2,000 w/ <25% PMNs
Characteristics of inflammatory (group II) fluid
yellow to white color- translucent to opaque
WBC 2,000-50,000 w/ >70% PMNs
Characteristics of septic (group III) fluid
White to cream- opaque
WBC >50,000 w/ >90% PMNs
Characteristics of hemorrhagic (group IV) fluid
hemorrhagic color- opaque
may have fat globules indicating fx
difficult to count cells
What may precipitate attacks of gout or pseudogout?
Widening of joint space on x-ray of the knee may be indicative of...?
tibial plateau fx
What imaging may be done to evaluate for an early osteomyelitis?
3 phase bone scan
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