-Poor prognosis of rheumatoid disease.

Poor prognosis of rheumatoid disease
"I'm fresh"

Insidious onset.
Male patient.

Functional disability at the 1st year after start of disease.
Radiographic evidence of erosion.
Extra-articular manifestations.
Subcutanous nodules.
High positive Rheumatoid factor.

Dr Ibrahim

-Grading of function in rheumataid disease.

Grading of function in rheumataid disease

I Fit for all activities.
II Moderate restriction.
III Marked restriction.
IV Confined to chair or bedbound.

Dr Ibrahim
Return to list of medical grades (click here)

- Caplan's syndrome.

Caplan's syndrome

*Def:-It is is a combination of rheumatoid arthritis and pneumoconiosis that manifests as intrapulmonary nodules.
*Synonyms:- rheumatoid pneumoconiosis.

*Causes:-

It occurs only in patient with both rheumatoid arthritis and pneumoconiosis related to mining dust (coal, asbestos, silica)so occurs in miners (especially those working in anthracite coal-mines), asbestosis, silicosis and other pneumoconioses.

- Felty's syndrome.

Felty's syndrome

*DeF:- It is a disorder characterized by the combination of rheumatoid arthritis, splenomegaly,neutropenia and repeated infections.
*It occurs in 5% of adult.

*Clinical picture:-

• Skin pigmentation and generalized lymphadenopathy.
• Splenomegaly.
• Hepatomegaly.
• Highly erosive and deforming arthiritis.
• L.E cells are +ve.
• Neutropenia so increase liability to certain infections.
• Fever, weight loss, and/or fatigue.

- ACR Criteria for Diagnosis of SLE.

American college of Rheumatology (ACR) Criteria

for Diagnosis of Systemic Lupus Erythematosus.

"Sharp Domain"

1. Serositis:Pleuritis, pericarditis.
2. Hematologic disorder (hemolytic anemia OR Leukopenia less than 4,000 OR Lymphopenia less than 1500 or thrombocytopenia less than 100,000).
3. Arthritis:-(nonerosive, involving 2 or more joints).
4. Renal disorder:-(persistent proteinuria > 0.5 grams per day OR cellular CASTS).
5. Photosensitivity:- Rash on exposure to sun light.
   
   

- Skin manifestations of Systemic Lupus Erythematosus.

Skin manifestations of Systemic Lupus Erythematosus.

"Dr Palm"

• Discoid rash.
• Raynaud's phenomenon: observed at distal digital tips.

• Photosensitivity, Purpuric lesion, Pre-ungual erythema.
• Alopecia:commonly affect the temporal regions.
• Lichen plannus like, Livedo reticularis, leucoderma.
• Malar rash.

Dr Ibrahim

-Sjögren's syndrome.

Sjögren's syndrome

(Sicca syndrome.)

*Def:-

It is chronic inflammatory autoimmune disorder in which immune cells attack and destroy the exocrine glands(1)that produce tears and saliva.

*synonymes:-

• Mikulicz disease.
• Sicca syndrome.

*It is named after Swedish ophthalmologist Henrik Sjögren(2)(1899–1986) who first described it.

*Pathology:-

It is characterized by unusual infiltration of these glands that are responsible for fluid production by lymphocytes, thus causing decreased saliva (dry mouth), decreased tear production (dry eyes), and drying of other mucous membranes.

- Carpal tunnel syndrome.

Carpal tunnel syndrome 

*Def:- is a medical condition in which the median nerve is compressed inside the flexor retinaculum leading to paresthesias, numbness and muscle weakness in the hand.

*Causes:-

Due to fibrosis,fluid accumulation,soft tissue or bone hypertrophy which my be due to:-

"MEDIAN TRAP"(1)

Myxoedema
Edema
Diabetes mellitus,Drugs(e.g Oral contraceptive pills)
Idiopathic
Acromegaly
Neoplasm 

Trauma,Typists(Occuptional).
Rheumatoid arthritis
Amyloidosis
Pregnancy