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RHEUMATIC
AND
GRANULOMATOUS
DISEASES
RHEUMATIC DISEASES
DEFINITION:
Painful conditions usually caused by
inflammation, swelling and pain in the
joints or muscl...
CAUSES:
1. Genetic
2. Environmental
- excessive stress on the joint
- repeated injury
- infection e.g. virus: Eptein-Barr
...
- RA occurs 2-3x more often in women than
in men
- Scleroderma – more common in women
- 80 – 90% diagnosed with fibromyalg...
1. OSTEOARTHRITIS (OA)
• most common type
• affects both the cartilage
and underlying bone
• there is damage to the
cartil...
2. RHEUMATOID ARTHRITIS (RA)
• inflammatory disease of the immune system
• targets first the synovium, resulting in pain,
...
3. JUVENILE ARTHRITIS
• most common form in
childhood
• may be associated with rashes
or fever
• may affect various parts ...
4. FIBROMYALGIA
• chronic disorder
• pain throughout the tissues that
support and move the bones
and joints (muscles and
t...
5. SYSTEMIC LUPUS ERYTHEMATOSUS
(SLE)
• autoimmune disease
• results in inflammation of and damage of
the joints, skin, ki...
6. SCLERODERMA
• also known as
systemic sclerosis
• “hard skin”: affects the
skin, blood vessels and
joints; may also affe...
7. SPONDYLOARTHROPATHY
• principally affects the spine
a) ankylosing spondylitis – affects people in
late adolescence or e...
8. INFECTIOUS ARTHRITIS
e.g. parvovirus arthritis
gonococcal arthritis
9. GOUT
• results from deposits of
needle-like crys...
10. POLYMYALGIA RHEUMATICA
• involves tendons, muscles,
ligaments and tissues
around the joint
11. POLYMYOSITIS
• inflamma...
12. PSORIATIC ARTHRITIS
• occurs in patients
with psoriasis
(scaling skin
disorder)
• affects the joints
at the ends of th...
13. BURSITIS
• inflammation of
the bursae (small
fluid – filled sac
that help reduce
friction between
bones and other
movi...
14. TENDINITIS (TENDONITIS)
• inflammation
of tendons
• caused by
overuse,
injury or
rheumatic
condition
15.PAGET’S DISEASE
(OSTEITIS DEFORMANS)
• chronic condition of bone
characterized by disorder of the
normal bone remodelin...
CAUSE: unknown
S/S: • commonly, no symptoms and
is often an incidental finding in X-
ray
• bone pain, deformity,
fracture ...
16. SJOGREN’S SYNDROME
• autoimmune
• attacks glands that secrete fluid, such as
tear and salivary glands
• inflammation w...
A. PRIMARY – when the condition develops by
itself
B. SECONDARY – when the condition
develops in combination with another
...
• common condition: 3-4% of adults in
U.K.
• second most common autoimmune
condition after RA
• most cases seen in ages 40...
• eye and mouth dryness:
artificial tears and saliva
• good eye and mouth
hygiene to prevent corneal
ulcers and tooth deca...
17. TEMPOROMANDIBULAR JOINT DISORDER
(TMD)
• occur as a result of problems with the jaw,
jaw joint and surrounding facial ...
CAUSE: unclear
POSSIBLE CAUSES:
• injury to the jaw, TMJ, muscles
of the head and neck
• grinding / clenching of the
teeth...
S/S: • pain or tenderness in the face, jaw
joint area, neck & shoulders, in or
around the ear
• lock-jaw in the open or cl...
DIAGNOSIS:
History
P.E.: TMJ Examination
Panoramic X-Ray
MRI / CT scans
CONSERVATIVE TREATMENT
• apply moist heat or cold packs
ice pack x 10 min. Do simple jaw
stretching exercises Apply a warm...
• low level laser therapy – reduce
the pain and inflammation as well
as increase range of motion
• splint or night guard –...
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Rheumatic and Granulomatous Diseases

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Rheumatic and Granulomatous Diseases

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Rheumatic and Granulomatous Diseases

  1. 1. RHEUMATIC AND GRANULOMATOUS DISEASES
  2. 2. RHEUMATIC DISEASES DEFINITION: Painful conditions usually caused by inflammation, swelling and pain in the joints or muscles, including loss of function of one or more connecting or supporting structures of the body. AREAS AFFECTED: joints, tendons, ligaments, bones and muscles.
  3. 3. CAUSES: 1. Genetic 2. Environmental - excessive stress on the joint - repeated injury - infection e.g. virus: Eptein-Barr Virus and Lupus 3. Gender Factor / Hormonal Factor - Lupus, RA, Scleroderma and Fibromyalgia – more common among women
  4. 4. - RA occurs 2-3x more often in women than in men - Scleroderma – more common in women - 80 – 90% diagnosed with fibromyalgia are women - Gout is more common in males than women; after menopause, the incidence of gout for women begins to rise - SLE – more common in women WHO IS AFFECTED BY RHEUMATIC DISEASE?
  5. 5. 1. OSTEOARTHRITIS (OA) • most common type • affects both the cartilage and underlying bone • there is damage to the cartilage (fraying and wearing) • joint pain and stiffness • disability results when the disease affects the spine and the weight bearing joints (knees and hips) EXAMPLES OF RHEUMATIC DISEASES
  6. 6. 2. RHEUMATOID ARTHRITIS (RA) • inflammatory disease of the immune system • targets first the synovium, resulting in pain, stiffness, swelling, joint damage and loss of function • affects joints of the hands and feet • symmetrical
  7. 7. 3. JUVENILE ARTHRITIS • most common form in childhood • may be associated with rashes or fever • may affect various parts of the body • pain stiffness, swelling, loss of function
  8. 8. 4. FIBROMYALGIA • chronic disorder • pain throughout the tissues that support and move the bones and joints (muscles and tendons) • patients may also experience fatigue and sleep disturbances
  9. 9. 5. SYSTEMIC LUPUS ERYTHEMATOSUS (SLE) • autoimmune disease • results in inflammation of and damage of the joints, skin, kidneys, heart, lungs, blood vessels and brain
  10. 10. 6. SCLERODERMA • also known as systemic sclerosis • “hard skin”: affects the skin, blood vessels and joints; may also affect the lungs and kidneys • abnormal and excessive production of collagen in the skin and internal organs
  11. 11. 7. SPONDYLOARTHROPATHY • principally affects the spine a) ankylosing spondylitis – affects people in late adolescence or early childhood b) reactive arthritis – develops after an infection involving the lower urinary tract, bowel or other organs; commonly associated with eye problems, skin rashes & mouth sores
  12. 12. 8. INFECTIOUS ARTHRITIS e.g. parvovirus arthritis gonococcal arthritis 9. GOUT • results from deposits of needle-like crystals of uric acid in the joints. • episodic inflammation, swelling & pain in the affected joint often the big toe
  13. 13. 10. POLYMYALGIA RHEUMATICA • involves tendons, muscles, ligaments and tissues around the joint 11. POLYMYOSITIS • inflammation and weakness in the muscles • may affect the whole body and cause disability
  14. 14. 12. PSORIATIC ARTHRITIS • occurs in patients with psoriasis (scaling skin disorder) • affects the joints at the ends of the fingers and toes accompanied by changes in the fingernails and toenails.
  15. 15. 13. BURSITIS • inflammation of the bursae (small fluid – filled sac that help reduce friction between bones and other moving structures in the joint
  16. 16. 14. TENDINITIS (TENDONITIS) • inflammation of tendons • caused by overuse, injury or rheumatic condition
  17. 17. 15.PAGET’S DISEASE (OSTEITIS DEFORMANS) • chronic condition of bone characterized by disorder of the normal bone remodeling process BONE REMODELING: normal bone can lay down new bone and take up old bone - essential for normal Ca++ levels in our blood • bone remodeling is disturbed and not synchronized: bone formed is abnormal, enlarged, not as dense, brittle and prone to fracture
  18. 18. CAUSE: unknown S/S: • commonly, no symptoms and is often an incidental finding in X- ray • bone pain, deformity, fracture and arthritis • affects spines, femur, pelvis, skull, clavicle and humerus
  19. 19. 16. SJOGREN’S SYNDROME • autoimmune • attacks glands that secrete fluid, such as tear and salivary glands • inflammation within the glands reduces the production of tears and saliva dry mouth and dry eyes
  20. 20. A. PRIMARY – when the condition develops by itself B. SECONDARY – when the condition develops in combination with another autoimmune condition (lupus or RA) CAUSES: unknown TRIGGERED BY: genetic environmental hormonal CLASSIFICATION OF SJOGREN’S SYNDROME
  21. 21. • common condition: 3-4% of adults in U.K. • second most common autoimmune condition after RA • most cases seen in ages 40-60 years old • 90% of cases are women WHO IS AFFECTED?
  22. 22. • eye and mouth dryness: artificial tears and saliva • good eye and mouth hygiene to prevent corneal ulcers and tooth decay TREATMENT
  23. 23. 17. TEMPOROMANDIBULAR JOINT DISORDER (TMD) • occur as a result of problems with the jaw, jaw joint and surrounding facial muscles that control chewing and jaw movement TMJ – the hinge that connects the lower jaw (mandible) to the temporal bone of the skull
  24. 24. CAUSE: unclear POSSIBLE CAUSES: • injury to the jaw, TMJ, muscles of the head and neck • grinding / clenching of the teeth • dislocation of the soft cushion or disc between the ball and socket • osteoarthritis or RA in TMJ • stress
  25. 25. S/S: • pain or tenderness in the face, jaw joint area, neck & shoulders, in or around the ear • lock-jaw in the open or closed mouth position • clicking, popping or grating sounds when opening or closing the mouth • tired feeling in the face • difficulty in chewing or sudden uncomfortable bite • swelling • toothache, headache, neckaches, earache
  26. 26. DIAGNOSIS: History P.E.: TMJ Examination Panoramic X-Ray MRI / CT scans
  27. 27. CONSERVATIVE TREATMENT • apply moist heat or cold packs ice pack x 10 min. Do simple jaw stretching exercises Apply a warm towel x 5 min. • eat soft foods • medications NSAID – naproxen, ibuprofen • anti-anxiety • muscle relaxant TREATMENT
  28. 28. • low level laser therapy – reduce the pain and inflammation as well as increase range of motion • splint or night guard – plastic mouthpiece • undergo corrective dental treatments e.g. replacing missing teeth and using crowns, bridges or braces • avoid extreme jaw movements

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