Rheumatology
!
Things to ask in Rheumatology History
Presenting Joints: pain, pattern of distribution, morning stiffness, swelling, loss of function!
Symptoms Extra-articular: rashes, photosensitivity, Raynaud’s, Alopecia, Dry eyes/mouth, Diarrhoea or
urethritis, red eyes, nodules or LN, mouth or genital ulcers, weight loss
Past history IBD, gout, venereal disease
Drug History Current therapy, previous medications (Esp. use of DMARDs)
Family History Arthritis/psoriasis
Social History Functional ability, dressing, writing walking, domestic situation, social support, adaptations.
!
Introduction to Rheumatology!
What is rheumatology? Diseases with locomotor of musculoskeletal
system:
- Locomotor system: functional
- Musculoskeletal system: structural
Rheumatic diseases
- Considered irreversible
- Considered to be part of normal aging process
- Low expectation of what can be achieved, both by public and
health professionals
- Lack of awareness of impact of diseases on society
! - Lack of training in management of these diseases
InDlammation: primitive role in many rheumatic diseases
How common are rheumatic disease?
- Over 200 different diseases
- About 30% of the population have symptoms of arthritis/back pain
- Rheumatic diseases may occur in men and in women at any age, but prevalence increases with age
What are the rheumatic diseases?
Classi1ication of rheumatic disease:
Diseases affecting:
- Joints (Articular)
o InDlammation in a joint
- Any component/s of the musculoskeletal
system lying outside the joint (peri-
articular)
o E.g. tennis elbow: irritation in
common extensor tendon
Diseases that may involve:
- One site (monoarticular)
- Many sites (polyarticular)
Diseases that may or may not be associated with
inDlammation (inDlammatory or non-inDlammatory)
!! - InDlammation classically associated with: Heat, redness, swelling, pain, loss of function, stiffness
!!
Framework of classifying rheumatic diseases: Dlow chart
RHEUMATOLOGY 1
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