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Examination methods in rheumatology
Terms in this set (22)
1. patient history
3. joint aspiration
6. Antineutrophil cytoplasmic antibodies ANCA
7Antiphospholipid antibody syndrome
8. blood tests
observation : observe walk of patient.
Joints : look
Any deformities? contractures?
palpable joint marging
synovial thickening? soft spongy feel
active movement : pat.utilizes own musclces and movest the joint
passive movement:examiner moves the joint
resisted movement : isolates to a particular tendon or bursa
upper extermit: from clavicle to hand
lower extremiti: hip joint to toes
sign of ulceration
if there is fluid in the joint it need analysis
the synovial fluid gets tested for 3C
inflammatory disease (RA,gout) have very high cell count
septic arthritis:even higher WBC
simple blood test
non specific acute phase response : CRP:ESR: with inflammatory arthrides
Normocytoic normcochromic anemia is common
hypochromic microcytic anemia:iron deficiency due to nSAIDs induced git bleeding.
ALP rise in bone disease
may helpt to establish diagnosisis
can be also used to monitor disease activity
e.g seropositive (RF+) is associated with more erosive joint disease and extraarticular manifestations then seronegative
DXA:dual energy x ray absorbent
plain x ray
may show fractures
soft tisse swelling
decreased bone densitiy
osteolytic and osteosclerotic area suggestive of metastais
joint space narrowinfg
new bone formation
x-ray me be normal in early inflammatory arthritis, but are used as a baseline for later comparison
-antibodies that have the capibility of binding to certain structures within the nucleus of cell.
found in patietns whose immune system may be predispoded to generated antibodies against body own tissue
ANA test is performed by exposing the antibodies in the serum of the blood to llav test cells.
+ fluoroscent tecnniques
there are also subset of anas associated with specific autoimmune diseases. and are used to further dg the diseases
anti dsDNA and anti -sm ab (ANA)
anti-histone ab (ANA)
drug induced lupus
is an autoantibdies against the Fe portion of IgG!!!
found in 70% of ppl with RA
not specific for RA.
ANti CCP: cyclic citrullinated peptide is also positive in RA.
therefore RF is neither sensitive nor specific for the dg of RA.
patient with ihigh titres tend to have more affresive disease.with extraarticular manifestaiton
antineutropil cytoplasmic antiabodies
directted against certain proteins in the cytoplasm of the neutrophil.
cytoplasmic ANCA :
seen in >90% of wegners granulomatosis
perinuclear ANCA: target is an enzyme
but not a specific test
antiphospholipid antibody syndrome
hypercoaguable state associated with a group of antibodies that are directed against phospholipids or cardiolipin.
preents with spontanous abortions or thromboembolism.
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