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Samenvatting Reumatologie
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Samenvatting reumatologie 1ste master geneeskunde universiteit Gent. No nonsense samenvattingen, enkel wat je moet kennen.
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InhoudLes 1 diagnostsche inleiding........................................................................................................................2
Les 2 inleiding reumato................................................................................................................................3
Les 3 SpondyloArtrits AKA SpA....................................................................................................................4
Spondylits Ankylosans AKA SA aka ziekte van Bechterew.......................................................................5
IBD............................................................................................................................................................7
Psoriasis artrits........................................................................................................................................8
Spondyloartrits........................................................................................................................................9
Fibromyalgie...........................................................................................................................................10
Chronisch vermoeidheid syndroom........................................................................................................10
Les 4 Reumatoide atrits.............................................................................................................................11
RA...........................................................................................................................................................11
Polymyalgia reumatca...........................................................................................................................13
Les 5 RA mechanismen...............................................................................................................................13
Les 7 cases..................................................................................................................................................15
Les 8 juveniele chronisch artrits................................................................................................................15
Systemic onset........................................................................................................................................16
Polyartculaire onset...............................................................................................................................16
Early pauciartculaire onset....................................................................................................................16
Late pauciartculaire onset.....................................................................................................................16
Les 9 systeemscelerose..............................................................................................................................18
Systeemsclerose.....................................................................................................................................18
RAYNAUD FENOMEEN SWS EXAMEN.....................................................................................................19
Les 10 septsche artrits..............................................................................................................................19
TBC artrits..............................................................................................................................................20
Infecteuze spondyloDiscits...................................................................................................................21
TBC spondylodiscits...............................................................................................................................22
Les 11 Bindweefsel ziekten en vasculitden................................................................................................22
SLE..........................................................................................................................................................22
Polymyositssdermatomyosists..............................................................................................................24
Les 12 vasculitden......................................................................................................................................24
Arterits temporalis of reuscelarterits....................................................................................................25
, Polymalgia reumatca.............................................................................................................................26
Takayatsu................................................................................................................................................26
PAN, poly arterits nodosum...................................................................................................................26
Ziekte van wegener................................................................................................................................26
Leukecytoclastsche vasculits.................................................................................................................26
Sjogren en ant fosfolipied syndroom.....................................................................................................27
Les 13 kristal artrits...................................................................................................................................27
Jicht........................................................................................................................................................27
Chondrocalcinosis...................................................................................................................................29
Les 14 osteoartrose....................................................................................................................................30
Osteoartrose...........................................................................................................................................30
Lesje 15 osteoporose..................................................................................................................................32
Cursus inhoud.............................................................................................................................................35
Les 1 diagnostische inleiding
Sensitviteit - Positves s positves + false negatves
- Indien hoog: negatef test resultaat -> je zal het niet
hebben
- Indien laag: negatef test resultaat betekent niet
dat je de ziekte niet hebt
Specifciteit - Negatves s negatves + false positves
- Indien hoog: Positef resultaat -> je hebt de ziekte
- Indien laag: positef resultaat -> je hebt het
misschien
Aspecifek labo - CRP
- ESR
- WBC
Specifek labo - RF
1. Neemt toe met de leefijd. 30 procent van de
healthy elderly
2. Gepaard met andere ziekten: TBC, endocardits,
sjogren, SLE
3. Sensitviteit 60-70, specifciteit 50-90. Dus veel
vals positeven mogelijk
- Ant CCP
1. Hoog specifciteit: indien positef ga je het bijna
zeker hebben
2. Sensitviteit 60-70
3. Hoog positef predicteve waarde
, - ANF
1. Belangrijk bij BW ziekten
2. Aanwezig in 20-30 procent gezonde populate
3. Aanwezig in 95 procent van patenten met SLE
- ANCA
1. Aanwezig in small vessel vasculitden
2. Tegen neutrofele granulocyten
HLA B27 Labo - 5-10 procent van white people
- Verhoogd OR op SpA -> 30-100x
Labo synoviaal vocht - Bij monoartrits zwelling -> SEPTISCH TENZIJ
TEGENDEEL BEWEZEN
- Altjd puncteren
Rx - Gouden standaard
- Lage sensitviteit -> vroege letsels vinden we niet
- Goed voor erosies, artrose, extra botvorming
Echo - Vroegtjdig erosies opsporen
- Informate over infammate en structuur
Bot scintgrafe - Zeer sensitef -> indien negatef zal er wel niets aan
de hand zijn
- Specifciteit is niet zo goed
- Geen verschil tussen degeneratef of infammatoir
MRI - Zeer sensitef
- Weinig specifek
- Indicates: sacroiliits, osteomyelits
CT - Sensitef en specifek which is nice
- Goed voor botsstructurele afwijkingen
- Niet zo goed voor infammatoire kenmerken
- Vooral erosies goed opspoorbaar
Sensitviteit en specifciteit goed kennen van de onderzoekeng
Echo
Rx specifek, weinig sensitef
MRI: sensitef, weinig specifek
botscint: Sensitef, weinig specifek
CT: Ok qua beide
Les 2 inleiding reumato
Gerefereerde pijn - Is niet altjd neurologischg Onthoudeng
- Schouder last -> laterale arm pijn
, - Laterale epicondyl last -> midden voorarm
- Lumbaal zuil -> poep, been voet, billen
- Regel: gewricht boven en onder kunnen last geven
Mechanische pijnsartrose - Pijn die toeneemt naar gelang de dag
- Beter na rust, verslechterd bij bewegen
- Geen nachtelijke pijn
Infammatoir pijnsartrits - Nachtelijke pijn
- Beter bij beweging
Z patroon - Polyartriculair, meer dan 5 gewrichten
- Symmetrisch patroon
- Distale gewrichten
- Vaak bij RA
Y patroon - Pauciartculair, minder dan 5 gewrichten
- Assymetrisch patroon
- Vaak OL
- Vaak bij SpA
Monosynovits - 1 gewrichtje
- UITSLUITEN JICHT EN SEPSIS
- Als eerste manifestate systeem problems -> RA,
psoriasis, Spa etc etc
Systeem anamnese Zeer kort overlopen in de les, lees keer
Familiale anamnese Zeker bij SpA
Les 3 SpondyloArtritis AKA SpA
GOED HERHALEN
Vrije jonge leefijd allemaal gelijk
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