Slideshow is from the University of Michigan Medical School's M2 Musculoskeletal sequence
View additional course materials on Open.Michigan:
openmi.ch/med-M2Muscu
Presentation1.pptx, radiological imaging of sacroiliac joint diseases.Abdellah Nazeer
This document discusses radiological imaging of sacroiliac joint diseases. It provides details on the anatomy and physiology of the sacroiliac joints, common pathological conditions like infections, and imaging findings on x-ray, CT, and MRI. Key points include that sacroiliac joints are susceptible to arthritis and trauma with age. Plain x-rays remain the most common initial imaging method but CT and MRI can detect changes earlier and better evaluate soft tissues. Common MRI findings in sacroiliitis include bone marrow edema, enhancement, and erosions in the acute phase and sclerosis, pannus formation, and ankylosis in the chronic phase.
This document discusses imaging of the sacroiliac joint, including radiography and MRI findings. It begins with an overview of sacroiliac joint anatomy. It then describes common radiographic views and classifications of sacroiliac joint damage. The document focuses on using MRI to identify inflammatory lesions in the sacroiliac joints that can indicate early spondyloarthritis. It discusses how stopping NSAIDs before MRI may have little impact on findings. Repeating sacroiliac MRI months later generally does not reveal new cases, except possibly in HLA-B27 positive men. The document recommends sacroiliac MRI over spine MRI alone for axial spondyloarthritis workup given the low yield of isolated spinal findings without sac
This document provides information on imaging mimics of sacroiliitis. It discusses how conditions like reactive arthritis, enteropathic arthropathy, infections, tumors, and other disorders can appear similar to sacroiliitis on imaging. It provides details on MRI protocols for evaluating the sacroiliac joints and spine. Common MRI findings in spondyloarthritis are described along with differential diagnoses. Guidelines are presented for simple MRI requests to assess for spondyloarthritis.
- A 17-year-old female presented with 2 months of lower back pain and 1 month of intermittent fever. On examination, she had tenderness over the sacral region and sacroiliac joints. Tests indicated sacroiliitis.
- Imaging and biopsy results suggested tuberculous infection of the sacroiliac joints. The patient was started on anti-tuberculosis treatment and showed improvement of symptoms.
- The case report describes an unusual presentation of sacroiliac joint tuberculosis in a young female patient, initially diagnosed as non-tuberculous sacroiliitis.
This document discusses seronegative spondyloarthropathies, which are musculoskeletal syndromes linked by common features including being negative for rheumatoid factor and often involving the axial skeleton. There are five main subgroups, including ankylosing spondylitis, psoriatic arthritis, reactive arthritis, enteropathic arthritis, and undifferentiated spondyloarthritis. The document then provides details on the clinical presentation and radiographic findings for each of these three conditions in three sample patient cases.
Mr. J, a 55-year-old security officer, presented with asymmetric joint pain involving his right ankle, knees, shoulder, and finger. His symptoms began acutely upon waking and were burning, migratory, and stiff. Tests showed an elevated ESR and reactive hepatitis C. He was diagnosed with reactive polyarthritis and treated conservatively with rest, analgesics, and anti-inflammatories. Reactive arthritis is a painful inflammatory arthritis that can occur after certain bacterial infections, especially in the genitals or bowel, and is associated with HLA-B27 positivity.
This document provides an overview of vasculitis, including:
1) Vasculitis is inflammation and necrosis of blood vessels that can lead to occlusion, ischemia, and multi-system organ dysfunction.
2) It is classified based on the size of affected vessels as well as the organ systems involved.
3) Diagnosis involves determining which organ systems are affected, excluding other potential causes, and obtaining biopsies of involved tissues when possible. Laboratory tests including ANCA can also provide clues to diagnosis.
Spondyloarthritis refers to a group of inflammatory diseases affecting the spine and joints. Key characteristics include inflammatory back pain, enthesitis, and extra-articular manifestations like psoriasis and uveitis. Ankylosing spondylitis is the prototype spondyloarthritis, typically causing inflammation in the sacroiliac joints and spine that leads to bony fusion over time. Psoriatic arthritis is another common subtype associated with psoriasis. Treatment focuses on reducing inflammation and preventing joint damage and deformity.
Presentation1.pptx, radiological imaging of sacroiliac joint diseases.Abdellah Nazeer
This document discusses radiological imaging of sacroiliac joint diseases. It provides details on the anatomy and physiology of the sacroiliac joints, common pathological conditions like infections, and imaging findings on x-ray, CT, and MRI. Key points include that sacroiliac joints are susceptible to arthritis and trauma with age. Plain x-rays remain the most common initial imaging method but CT and MRI can detect changes earlier and better evaluate soft tissues. Common MRI findings in sacroiliitis include bone marrow edema, enhancement, and erosions in the acute phase and sclerosis, pannus formation, and ankylosis in the chronic phase.
This document discusses imaging of the sacroiliac joint, including radiography and MRI findings. It begins with an overview of sacroiliac joint anatomy. It then describes common radiographic views and classifications of sacroiliac joint damage. The document focuses on using MRI to identify inflammatory lesions in the sacroiliac joints that can indicate early spondyloarthritis. It discusses how stopping NSAIDs before MRI may have little impact on findings. Repeating sacroiliac MRI months later generally does not reveal new cases, except possibly in HLA-B27 positive men. The document recommends sacroiliac MRI over spine MRI alone for axial spondyloarthritis workup given the low yield of isolated spinal findings without sac
This document provides information on imaging mimics of sacroiliitis. It discusses how conditions like reactive arthritis, enteropathic arthropathy, infections, tumors, and other disorders can appear similar to sacroiliitis on imaging. It provides details on MRI protocols for evaluating the sacroiliac joints and spine. Common MRI findings in spondyloarthritis are described along with differential diagnoses. Guidelines are presented for simple MRI requests to assess for spondyloarthritis.
- A 17-year-old female presented with 2 months of lower back pain and 1 month of intermittent fever. On examination, she had tenderness over the sacral region and sacroiliac joints. Tests indicated sacroiliitis.
- Imaging and biopsy results suggested tuberculous infection of the sacroiliac joints. The patient was started on anti-tuberculosis treatment and showed improvement of symptoms.
- The case report describes an unusual presentation of sacroiliac joint tuberculosis in a young female patient, initially diagnosed as non-tuberculous sacroiliitis.
This document discusses seronegative spondyloarthropathies, which are musculoskeletal syndromes linked by common features including being negative for rheumatoid factor and often involving the axial skeleton. There are five main subgroups, including ankylosing spondylitis, psoriatic arthritis, reactive arthritis, enteropathic arthritis, and undifferentiated spondyloarthritis. The document then provides details on the clinical presentation and radiographic findings for each of these three conditions in three sample patient cases.
Mr. J, a 55-year-old security officer, presented with asymmetric joint pain involving his right ankle, knees, shoulder, and finger. His symptoms began acutely upon waking and were burning, migratory, and stiff. Tests showed an elevated ESR and reactive hepatitis C. He was diagnosed with reactive polyarthritis and treated conservatively with rest, analgesics, and anti-inflammatories. Reactive arthritis is a painful inflammatory arthritis that can occur after certain bacterial infections, especially in the genitals or bowel, and is associated with HLA-B27 positivity.
This document provides an overview of vasculitis, including:
1) Vasculitis is inflammation and necrosis of blood vessels that can lead to occlusion, ischemia, and multi-system organ dysfunction.
2) It is classified based on the size of affected vessels as well as the organ systems involved.
3) Diagnosis involves determining which organ systems are affected, excluding other potential causes, and obtaining biopsies of involved tissues when possible. Laboratory tests including ANCA can also provide clues to diagnosis.
Spondyloarthritis refers to a group of inflammatory diseases affecting the spine and joints. Key characteristics include inflammatory back pain, enthesitis, and extra-articular manifestations like psoriasis and uveitis. Ankylosing spondylitis is the prototype spondyloarthritis, typically causing inflammation in the sacroiliac joints and spine that leads to bony fusion over time. Psoriatic arthritis is another common subtype associated with psoriasis. Treatment focuses on reducing inflammation and preventing joint damage and deformity.
12.01.08(b): Immunosuppressive Therapies for Rheumatic DiseasesOpen.Michigan
Slideshow is from the University of Michigan Medical School's M2 Musculoskeletal sequence
View additional course materials on Open.Michigan:
openmi.ch/med-M2Muscu
This is a lecture by Dr. Joseph Hartmann from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
GEMC- Lower Extremity Injuries- Resident Training Open.Michigan
This is a lecture by Dr, John Burkhardt from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
The document provides an overview of common lower extremity injuries involving the knee, ankle, and foot that present in emergency departments. It reviews the epidemiology, history, physical exam, diagnostic workup, and initial management of injuries to structures like the ligaments, bones, meniscus, and articular cartilage in the knee. Key points covered include evaluating for effusions, assessing range of motion and joint stability, and implementing decision rules like the Ottawa Knee Rules to determine if imaging is needed. Initial treatment focuses on splinting, immobilization, referral to orthopedics, and considering surgical intervention for unstable or displaced fractures.
GEMC- Bursitis, Tendonitis, Fibromyalgia, and RSD- Resident TrainingOpen.Michigan
This is a lecture by Joe Lex, MD from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
12.04.09: Autoantibodies and Rheumatologic Diseases: When and How to Use Lab ...Open.Michigan
Slideshow is from the University of Michigan Medical School's M2 Musculoskeletal sequence
View additional course materials on Open.Michigan:
openmi.ch/med-M2Muscu
GEMC- Injuries of the Lower Extremity: Knee, Ankle and Foot- Resident TrainingOpen.Michigan
This is a lecture by Dr. John Burkhardt from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
GEMC: Collagen Vascular Disease: Considerations for Emergent Management: Resi...Open.Michigan
This is a lecture by Dr. Joseph Hartmann from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
GEMC- Arthritis and Arthrocentesis- Resident TrainingOpen.Michigan
This is a lecture by Joe Lex, MD from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
Slideshow is from the University of Michigan Medical School's M2 Respiratory sequence
View additional course materials on Open.Michigan:
openmi.ch/med-M2Resp
GEMC - Bone and Joint Infections - Resident TrainingOpen.Michigan
This is a lecture by Dr. Keith Kocher from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
This is a lecture by Dr. Keith Kocher from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
GEMC - Abdominal Emergencies- For NursesOpen.Michigan
The document provides an overview of abdominal emergencies including objectives, assessment techniques, common conditions, and management strategies. Specifically, it reviews abdominal trauma, diagnosis, abdominal focused exam, common abdominal structures, diagnostic procedures, nursing considerations, documentation, and key factors for geriatric and pediatric patients. Common conditions discussed in detail include gastritis, ulcers, bowel obstructions, and gastroenteritis.
GEMC - Musculoskeletal Emergencies - for NursesOpen.Michigan
This is a lecture by Katherine A Perry from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
GEMC: Mesenteric Ischemia: Resident Training Open.Michigan
This is a lecture by Dr. Andrew Barnosky from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
GEMC- Approach to Acute Chest Pain- for ResidentsOpen.Michigan
This is a lecture by Rockefeller Oteng from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
This document provides information on autoimmune disorders like rheumatoid arthritis and systemic lupus erythematosus. It explains that autoimmunity occurs when the immune system attacks the body's own cells, causing diseases. Rheumatoid arthritis specifically causes joint inflammation and damage through autoantibodies attacking joint linings. Systemic lupus erythematosus more broadly attacks tissues, producing symptoms like rashes, fever, and kidney issues. Both have no cure but can be treated to reduce immune response and manage symptoms.
This document provides an overview of ankylosing spondylitis (AS), including its definition, epidemiology, etiology, pathogenesis, clinical manifestations, investigations, and management. Some key points:
- AS is a chronic inflammatory disease affecting the axial skeleton and sacroiliac joints that can lead to fusion and rigidity of the spine. It has strong genetic associations with HLA-B27.
- Symptoms include lower back pain and stiffness that typically worsens in the morning. Advanced cases can develop a fixed "question mark" posture.
- Investigations include blood tests, imaging like X-rays and MRI to assess sacroiliac joint involvement, and mobility tests. HLA-B27
This is a lecture by Katherine A Perry from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
12.01.08(a): Rheumatoid Arthritis/Pathogenesis and Clinical Presentation of J...Open.Michigan
Rheumatoid arthritis is caused by a complex interplay of genetic and environmental factors. Genetic susceptibility involves genes related to cellular immune responses, including HLA-DR4 alleles. Environmental triggers may include infection or smoking. The disease involves a dysregulated immune response in the synovium, with synoviocyte transformation and interaction with macrophages, T cells, and cytokines leading to inflammation and joint destruction. Autoantibodies such as rheumatoid factor and anti-CCP antibodies are involved in pathogenesis but their exact roles are still being elucidated.
This is a lecture by Joe Lex, MD from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
This is a lecture by Jim Holliman, MD from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
More Related Content
Similar to 12.02.09(a): Other Inflammatory Arthritides
12.01.08(b): Immunosuppressive Therapies for Rheumatic DiseasesOpen.Michigan
Slideshow is from the University of Michigan Medical School's M2 Musculoskeletal sequence
View additional course materials on Open.Michigan:
openmi.ch/med-M2Muscu
This is a lecture by Dr. Joseph Hartmann from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
GEMC- Lower Extremity Injuries- Resident Training Open.Michigan
This is a lecture by Dr, John Burkhardt from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
The document provides an overview of common lower extremity injuries involving the knee, ankle, and foot that present in emergency departments. It reviews the epidemiology, history, physical exam, diagnostic workup, and initial management of injuries to structures like the ligaments, bones, meniscus, and articular cartilage in the knee. Key points covered include evaluating for effusions, assessing range of motion and joint stability, and implementing decision rules like the Ottawa Knee Rules to determine if imaging is needed. Initial treatment focuses on splinting, immobilization, referral to orthopedics, and considering surgical intervention for unstable or displaced fractures.
GEMC- Bursitis, Tendonitis, Fibromyalgia, and RSD- Resident TrainingOpen.Michigan
This is a lecture by Joe Lex, MD from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
12.04.09: Autoantibodies and Rheumatologic Diseases: When and How to Use Lab ...Open.Michigan
Slideshow is from the University of Michigan Medical School's M2 Musculoskeletal sequence
View additional course materials on Open.Michigan:
openmi.ch/med-M2Muscu
GEMC- Injuries of the Lower Extremity: Knee, Ankle and Foot- Resident TrainingOpen.Michigan
This is a lecture by Dr. John Burkhardt from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
GEMC: Collagen Vascular Disease: Considerations for Emergent Management: Resi...Open.Michigan
This is a lecture by Dr. Joseph Hartmann from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
GEMC- Arthritis and Arthrocentesis- Resident TrainingOpen.Michigan
This is a lecture by Joe Lex, MD from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
Slideshow is from the University of Michigan Medical School's M2 Respiratory sequence
View additional course materials on Open.Michigan:
openmi.ch/med-M2Resp
GEMC - Bone and Joint Infections - Resident TrainingOpen.Michigan
This is a lecture by Dr. Keith Kocher from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
This is a lecture by Dr. Keith Kocher from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
GEMC - Abdominal Emergencies- For NursesOpen.Michigan
The document provides an overview of abdominal emergencies including objectives, assessment techniques, common conditions, and management strategies. Specifically, it reviews abdominal trauma, diagnosis, abdominal focused exam, common abdominal structures, diagnostic procedures, nursing considerations, documentation, and key factors for geriatric and pediatric patients. Common conditions discussed in detail include gastritis, ulcers, bowel obstructions, and gastroenteritis.
GEMC - Musculoskeletal Emergencies - for NursesOpen.Michigan
This is a lecture by Katherine A Perry from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
GEMC: Mesenteric Ischemia: Resident Training Open.Michigan
This is a lecture by Dr. Andrew Barnosky from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
GEMC- Approach to Acute Chest Pain- for ResidentsOpen.Michigan
This is a lecture by Rockefeller Oteng from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
This document provides information on autoimmune disorders like rheumatoid arthritis and systemic lupus erythematosus. It explains that autoimmunity occurs when the immune system attacks the body's own cells, causing diseases. Rheumatoid arthritis specifically causes joint inflammation and damage through autoantibodies attacking joint linings. Systemic lupus erythematosus more broadly attacks tissues, producing symptoms like rashes, fever, and kidney issues. Both have no cure but can be treated to reduce immune response and manage symptoms.
This document provides an overview of ankylosing spondylitis (AS), including its definition, epidemiology, etiology, pathogenesis, clinical manifestations, investigations, and management. Some key points:
- AS is a chronic inflammatory disease affecting the axial skeleton and sacroiliac joints that can lead to fusion and rigidity of the spine. It has strong genetic associations with HLA-B27.
- Symptoms include lower back pain and stiffness that typically worsens in the morning. Advanced cases can develop a fixed "question mark" posture.
- Investigations include blood tests, imaging like X-rays and MRI to assess sacroiliac joint involvement, and mobility tests. HLA-B27
This is a lecture by Katherine A Perry from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
12.01.08(a): Rheumatoid Arthritis/Pathogenesis and Clinical Presentation of J...Open.Michigan
Rheumatoid arthritis is caused by a complex interplay of genetic and environmental factors. Genetic susceptibility involves genes related to cellular immune responses, including HLA-DR4 alleles. Environmental triggers may include infection or smoking. The disease involves a dysregulated immune response in the synovium, with synoviocyte transformation and interaction with macrophages, T cells, and cytokines leading to inflammation and joint destruction. Autoantibodies such as rheumatoid factor and anti-CCP antibodies are involved in pathogenesis but their exact roles are still being elucidated.
Similar to 12.02.09(a): Other Inflammatory Arthritides (20)
This is a lecture by Joe Lex, MD from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
This is a lecture by Jim Holliman, MD from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
This is a lecture by Joe Lex, MD from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
GEMC- Alterations in Body Temperature: The Adult Patient with a Fever- Reside...Open.Michigan
This is a lecture by Joe Lex, MD from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
GEMC- Rapid Sequence Intubation & Emergency Airway Support in the Pediatric E...Open.Michigan
This is a lecture by Michele Nypaver, MD from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
This document provides an overview of ocular emergencies. It begins with an introduction to the Project: Ghana Emergency Medicine Collaborative and author information. The bulk of the document consists of slides reviewing various eye conditions and emergencies, including styes, chalazions, conjunctivitis, iritis, orbital cellulitis, subconjunctival hemorrhages, and scleritis. Treatment approaches are provided for many of the conditions. The document concludes with a discussion of the eye examination approach and areas to be reviewed.
GEMC- Disorders of the Pleura, Mediastinum, and Chest Wall- Resident TrainingOpen.Michigan
This document provides an overview of disorders of the pleura, mediastinum, and chest wall. It discusses several topics in 1-3 sentences each, including costochondritis (inflammation of the costal cartilages), mediastinitis (infection of the mediastinum), mediastinal masses, pneumothorax (air in the pleural space), and catamenial pneumothorax (recurrent pneumothorax associated with menstruation). The document aims to enhance understanding of the major clinical disorders commonly encountered in emergency medicine involving the pleura, mediastinum, and chest wall.
GEMC- Dental Emergencies and Common Dental Blocks- Resident TrainingOpen.Michigan
This is a lecture by Joe Lex, MD from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
This is a lecture by Joe Lex, MD from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
GEMC- Right Upper Quadrant Ultrasound- Resident TrainingOpen.Michigan
This is a lecture by Jeff Holmes from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
The document summarizes cardiovascular topics including pericardial tamponade, pericarditis, infective endocarditis, hypertension, tumors, and valvular disorders. It provides details on the causes, signs and symptoms, diagnostic studies, and management of these conditions. The document also includes bonus sections on cardiac transplant patients, pacemakers and ICDs, and EKG morphology.
This is a lecture by Joe Lex, MD from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
This is a lecture by Joe Lex, MD from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
GEMC: Nursing Process and Linkage between Theory and PracticeOpen.Michigan
This is a lecture by Jeremy Lapham from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
2014 gemc-nursing-lapham-general survey and patient care managementOpen.Michigan
This is a lecture by Dr. Jeremy Lapham from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
This document discusses the evaluation and management of patients with kidney failure presenting to the emergency department. It covers causes of acute kidney injury including pre-renal, intra-renal and post-renal failure. It also discusses evaluation of kidney function, risks of intravenous contrast, dialysis indications and complications in chronic kidney disease patients including infection, cardiovascular issues and electrolyte abnormalities. Special considerations are outlined for resuscitating, evaluating and treating kidney failure patients in the emergency setting.
GEMC: The Role of Radiography in the Initial Evaluation of C-Spine TraumaOpen.Michigan
This is a lecture by Dr. Stephen Hartsell from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
This is a lecture by Dr. Jim Holliman from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
GEMC- Sickle Cell Disease: Special Considerations in Pediatrics- Resident Tra...Open.Michigan
This is a lecture by Hannah Smith, MD from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
GEMC- Ghana Grab Bag Pediatric Quiz- Resident TrainingOpen.Michigan
This is a lecture by Hannah Smith, MD and Ruth S. Hwu, MD from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
Walmart Business+ and Spark Good for Nonprofits.pdfTechSoup
"Learn about all the ways Walmart supports nonprofit organizations.
You will hear from Liz Willett, the Head of Nonprofits, and hear about what Walmart is doing to help nonprofits, including Walmart Business and Spark Good. Walmart Business+ is a new offer for nonprofits that offers discounts and also streamlines nonprofits order and expense tracking, saving time and money.
The webinar may also give some examples on how nonprofits can best leverage Walmart Business+.
The event will cover the following::
Walmart Business + (https://business.walmart.com/plus) is a new shopping experience for nonprofits, schools, and local business customers that connects an exclusive online shopping experience to stores. Benefits include free delivery and shipping, a 'Spend Analytics” feature, special discounts, deals and tax-exempt shopping.
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Spark Good (walmart.com/sparkgood) is a charitable platform that enables nonprofits to receive donations directly from customers and associates.
Answers about how you can do more with Walmart!"
This presentation was provided by Steph Pollock of The American Psychological Association’s Journals Program, and Damita Snow, of The American Society of Civil Engineers (ASCE), for the initial session of NISO's 2024 Training Series "DEIA in the Scholarly Landscape." Session One: 'Setting Expectations: a DEIA Primer,' was held June 6, 2024.
it describes the bony anatomy including the femoral head , acetabulum, labrum . also discusses the capsule , ligaments . muscle that act on the hip joint and the range of motion are outlined. factors affecting hip joint stability and weight transmission through the joint are summarized.
How to Fix the Import Error in the Odoo 17Celine George
An import error occurs when a program fails to import a module or library, disrupting its execution. In languages like Python, this issue arises when the specified module cannot be found or accessed, hindering the program's functionality. Resolving import errors is crucial for maintaining smooth software operation and uninterrupted development processes.
LAND USE LAND COVER AND NDVI OF MIRZAPUR DISTRICT, UPRAHUL
This Dissertation explores the particular circumstances of Mirzapur, a region located in the
core of India. Mirzapur, with its varied terrains and abundant biodiversity, offers an optimal
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advanced technologies such as GIS (Geographic Information Systems) and Remote sensing to
analyze the transformations that have taken place over the course of a decade.
The complex relationship between human activities and the environment has been the focus
of extensive research and worry. As the global community grapples with swift urbanization,
population expansion, and economic progress, the effects on natural ecosystems are becoming
more evident. A crucial element of this impact is the alteration of vegetation cover, which plays a
significant role in maintaining the ecological equilibrium of our planet.Land serves as the foundation for all human activities and provides the necessary materials for
these activities. As the most crucial natural resource, its utilization by humans results in different
'Land uses,' which are determined by both human activities and the physical characteristics of the
land.
The utilization of land is impacted by human needs and environmental factors. In countries
like India, rapid population growth and the emphasis on extensive resource exploitation can lead
to significant land degradation, adversely affecting the region's land cover.
Therefore, human intervention has significantly influenced land use patterns over many
centuries, evolving its structure over time and space. In the present era, these changes have
accelerated due to factors such as agriculture and urbanization. Information regarding land use and
cover is essential for various planning and management tasks related to the Earth's surface,
providing crucial environmental data for scientific, resource management, policy purposes, and
diverse human activities.
Accurate understanding of land use and cover is imperative for the development planning
of any area. Consequently, a wide range of professionals, including earth system scientists, land
and water managers, and urban planners, are interested in obtaining data on land use and cover
changes, conversion trends, and other related patterns. The spatial dimensions of land use and
cover support policymakers and scientists in making well-informed decisions, as alterations in
these patterns indicate shifts in economic and social conditions. Monitoring such changes with the
help of Advanced technologies like Remote Sensing and Geographic Information Systems is
crucial for coordinated efforts across different administrative levels. Advanced technologies like
Remote Sensing and Geographic Information Systems
9
Changes in vegetation cover refer to variations in the distribution, composition, and overall
structure of plant communities across different temporal and spatial scales. These changes can
occur natural.
Leveraging Generative AI to Drive Nonprofit InnovationTechSoup
In this webinar, participants learned how to utilize Generative AI to streamline operations and elevate member engagement. Amazon Web Service experts provided a customer specific use cases and dived into low/no-code tools that are quick and easy to deploy through Amazon Web Service (AWS.)
Main Java[All of the Base Concepts}.docxadhitya5119
This is part 1 of my Java Learning Journey. This Contains Custom methods, classes, constructors, packages, multithreading , try- catch block, finally block and more.
This presentation includes basic of PCOS their pathology and treatment and also Ayurveda correlation of PCOS and Ayurvedic line of treatment mentioned in classics.
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বাংলাদেশের অর্থনৈতিক সমীক্ষা ২০২৪ [Bangladesh Economic Review 2024 Bangla.pdf] কম্পিউটার , ট্যাব ও স্মার্ট ফোন ভার্সন সহ সম্পূর্ণ বাংলা ই-বুক বা pdf বই " সুচিপত্র ...বুকমার্ক মেনু 🔖 ও হাইপার লিংক মেনু 📝👆 যুক্ত ..
আমাদের সবার জন্য খুব খুব গুরুত্বপূর্ণ একটি বই ..বিসিএস, ব্যাংক, ইউনিভার্সিটি ভর্তি ও যে কোন প্রতিযোগিতা মূলক পরীক্ষার জন্য এর খুব ইম্পরট্যান্ট একটি বিষয় ...তাছাড়া বাংলাদেশের সাম্প্রতিক যে কোন ডাটা বা তথ্য এই বইতে পাবেন ...
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বিসিএস ও ব্যাংক এর লিখিত পরীক্ষা ...+এছাড়া মাধ্যমিক ও উচ্চমাধ্যমিকের স্টুডেন্টদের জন্য অনেক কাজে আসবে ...
1. Author(s): Seetha Monrad, M.D., 2009
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5. Seronegative
spondyloarthropathies
• Seronegative: Not associated with
rheumatoid factor or other autoantibodies
• Spondyloarthropathy
– Spine and sacroiliac joints
– Variable peripheral involvement
– Variable extraarticular manifestations
• Prototypic spondyloarthropathy:
Ankylosing spondylitis
6. Case
• A 29 year old man presents to clinic complaining of back
pain for the past 2 years. He initially noticed it after lifting
a heavy box, but the pain has persisted. It is especially
bad in the morning; he states it takes him almost two
hours to get going . He also notes discomfort in his
buttocks and occasionally in his heels. He states that his
grandfather had a bad back and was always extremely
hunched over.
• On exam, he is unable to bend forward and touch his
toes. Modified Schober s maneuver reveals only 2 cm of
lumbar expansion with forward flexion.
15. Cervical spine Thoracic spine
American College of Rheumatology
American College of Rheumatology
16. J. Klippel. Primer on the Rheumatic Diseases. 13th Ed. Springer Science+Media Business, LLC. 2008
17. AS: Extraarticular manifestations
• Anterior uveitis
– 1/3 of patients
– Unilateral, alternating
– Does not mirror AS flares
• Inflammatory bowel
disease
– 10-15% have overt
disease
– 60% have subclinical
bowel inflammation Source Undetermined
– Does not mirror AS flares
19. Pathogenesis: HLA B27?
• Allele of MHC 1
• More than 30 subtypes
• Present in >90% of patients with AS (Caucasian males),
50-75% of other spondyloarthropathies
• Theories:
– B27 causes improper handling of microbes ->
inflammation
– B27 is an autoantigen (on its own or after aberrant
processing)
– B27 binds peptides that trigger activation of
autoreactive CD8 T cells
• Evidence: certain strains of B27 transgenic rats develop
arthritis/gastroenteritis/rash IF exposed to GI microbes
20. Pathogenesis: HLA B27
• However….
– 5-15% of general population is HLA B27+ (mostly Caucasian)
• 2% of African Americans; but only ~50% of African American AS
patients are B27+
– Only a few B27 subtypes associated with AS
– <5% of B27+ patients develop AS
• 20% chance of AS development in B27+ relatives of AS patients
• So…
– If patient has convincing inflammatory-type back pain, absence
of HLA-B27 helpful to rule out AS….
– IF patient is a Caucasian male
• Fundamentally: we don t routinely order
21. Psoriatic arthritis
• Up to 1/3 of patients with
psoriasis develop an
inflammatory arthritis
• Prevalence: 0.1-1%
• M:F 1:1
• Classified as a
spondyloarthropathy
because:
– Seronegative
– Spinal/sacroiliac
involvement
– Similar extrarticular
features
– Association with HLA-B27 American College of Rheumatology
29. Treatment
• Similar to ankylosing spondylitis
• Methotrexate, sulfasalazine more effective
(peripheral arthritis)
– ?liver toxicity
• Other biologics: alefacept, abatacept
30. Reactive arthritis
• Sterile arthritis developing after a non-
articular infection
• Formerly known as Reiter s syndrome
(1916): non-gonococcal urethritis,
conjunctivitis (uveitis), arthritis
31. Reactive arthritis
• ~50% post Chlamydia, Salmonella,
Shigella, Yersinia, Campylobacter
• Characteristically an asymmetric lower
extremity oligoarthritis
• Enthesitis common (Achilles tendonitis,
plantar fasciitis)
• Sacroiliitis in 50%, but rare progression to
ankylosing spondylitis
38. Enteropathic spondyloarthritis
• Inflammatory bowel disease: Ulcerative
colitis and Crohn s disease
• Develop arthritis in 10-20%
– Peripheral:
• Pauciarticular, asymmetric, favors lower
extremities
• Nonerosive
• Often correlated with bowel disease
– Colectomy in UC->arthritis remission
– Axial: like AS
• Activity does NOT parallel bowel disease
39. Enteropathic spondyloarthritis
• Extraarticular manifestations:
– Skin: erythema nodsum, pyoderma
gangrenosum
– Uveitis, oral ulcers
• Treatment:
– Minimize NSAID use
– SSZ: common treatment for IBD
– TNF blockers:
• Infliximab, adalimumab treat bowel disease also
• Etanercept: doesn’t work for bowel
40. Case
• A 70-year-old man with diabetes who has
been on hemodialysis for 6 years
developed severe pain and swelling in the
right knee several hours after playing golf.
He also noted that during the dialysis run
that morning he had had a chill but felt well
• Past history includes three attacks of gout
in the left great toe and the right knee 2
years before starting dialysis
41. • He has difficulty getting onto the
examination table because of knee pain.
Temperature 101°F, pulse 100 bpm, BP
150/90. He is diaphoretic over the face
and arms. The skin over the AV fistula is
slightly erythematous, but the bruit is
strong. There are two small abrasions over
the left elbow. Examination of HEENT,
chest, and abdomen are normal
42. Physical Findings
• The right knee is The image cannot be displayed. Your computer may not have enough memory to open the image, or the image may have been corrupted. Restart your computer,
and then open the file again. If the red x still appears, you may have to delete the image and then insert it again.
swollen, slightly
reddened, warm, and
tender to palpation
over the medial and
lateral joint margins.
Both active and
passive flexion and
extension are limited Source Undetermined
by pain. There is no
laxity, but the exam is
limited by pain.
43. Step 1: Characterize This Illness
• Acute inflammatory monoarticular arthritis
and fever within 24 hours of dialysis,
vigorous physical activity, and perhaps
trauma in a patient with a history of gout
• Signs of systemic illness: Fever,
diaphoresis
• Initial laboratory tests: WBC 22,000 with
95% PMNs, Hgb 10 g%
44. Question 1: What Is Differential
Dx?
A. Knee trauma with hemarthrosis
B. Crystalline arthritis
C. Pre-patellar bursitis
D. Septic arthritis
45. Incorrect Answers
C. Prepatellar bursitis
produces pain,
swelling, and
erythema but does
not limit extension of
the knee Source Undetermined
46. Differential Dx
• The differential diagnosis includes A, B,
and D
A. Hemarthrosis with mild trauma could occur in
renal failure because of tissue fragility and
platelet dysfunction
B. Patients with crystalline arthritis in renal
failure may show uric acid, oxalate, apatite,
or CPPD crystals
D. Bone and joint infections are common in
dialysis patients because of vascular access
and impaired immune defenses
47. Question 2: What Diagnostic
Tests?
A. Bone scan
B. X-ray of knee
C. Arthroscopy
D. MRI of knee
E. Arthrocentesis and synovial fluid
analysis
48. Question 2: Answer
• Key point: TAP THE JOINT! Diagnosis must be made
immediately. X-ray of the knee should be done if the tap
is bloody. Synovial fluid analysis will differentiate
between infection and crystals
Source Undetermined
49. Synovial Fluid Findings
• Synovial fluid WBC
100,000 with 98%
PMNs
• No crystals seen on
polarizing microscopy
• SF culture and
sensitivity test request
sent to the
microbiology lab
Blood cultures sent
Source Undetermined
•
• SF gram stain
50. Septic arthritis – non-
gonococcal
• Risk factors • Pathogenesis
– Increasing age – Bacteremic seeding of
– Diabetes joint from distant source
– Alcoholism of infection
– RA – Much less common:
direct innoculation of
– Prosthetic joint/recent
joint
joint surgery
– Skin infection
– Impaired immune system
– Hemodialysis patients
– IV drug users
52. Treatment
• Antibiotics
– Nafcillin/oxacillin
– Vancomycin for MRSA
– 3rd generation cephalosporin
• Drainage of the infected joints
53. Gonococcal arthritis
• Typically healthy, sexually
active adults
• Women more susceptible
• Presents with migratory
arthritis, tenosynovitis, +
skin lesions
• Diagnosis:
– GS/Cx of synovial fluid
typically negative
– Need to culture extra-
articular sites (GU tract,
rectum, throat) American College of Rheumatology
• Treatment: 3rd
generation
cephalosporin
56. Additional Source Information
for more information see: http://open.umich.edu/wiki/CitationPolicy
Slide 9: American College of Rheumatology; American College of Rheumatology
Slide 10: American College of Rheumatology
Slide 12: American College of Rheumatology
Slide 13: American College of Rheumatology
Slide 14: American College of Rheumatology; American College of Rheumatology
Slide 15: American College of Rheumatology
Slide 16: J. Klippel. Primer on the Rheumatic Diseases. 13th Ed. Springer Science+Media Business, LLC. 2008
Slide 17: Source Undetermined
Slide 21: American College of Rheumatology
Slide 23: American College of Rheumatology
Slide 24: American College of Rheumatology
Slide 25: American College of Rheumatology
Slide 26: American College of Rheumatology
Slide 27: American College of Rheumatology
Slide 28: American College of Rheumatology
Slide 32: American College of Rheumatology
Slide 33: American College of Rheumatology
Slide 34: American College of Rheumatology
Slide 36: American College of Rheumatology
Slide 37: American College of Rheumatology
Slide 42: Source Undetermined
Slide 45: Source Undetermined
Slide 48: Source Undetermined
Slide 49: Source Undetermined
Slide 49: American College of Rheumatology; American College of Rheumatology
Slide 53: American College of Rheumatology