This document provides an overview of various rheumatologic disorders including their classification, symptoms, physical exam findings, and management considerations for dental patients. Key points include:
1. Rheumatologic disorders are classified as joint, degenerative, inflammatory, connective tissue, spondarthritis, autoimmune, or crystal arthropathy diseases. Common conditions discussed are osteoarthritis, rheumatoid arthritis, and gout.
2. Physical exam findings help differentiate conditions based on factors like joint involvement, inflammation signs, range of motion, and presence of extra-articular manifestations.
3. Laboratory/radiology tests are used to confirm diagnoses but can be misleading. Synovial fluid analysis and antibody/acute phase reactant testing
Welcome to TechSoup New Member Orientation and Q&A (May 2024).pdfTechSoup
In this webinar you will learn how your organization can access TechSoup's wide variety of product discount and donation programs. From hardware to software, we'll give you a tour of the tools available to help your nonprofit with productivity, collaboration, financial management, donor tracking, security, and more.
The Indian economy is classified into different sectors to simplify the analysis and understanding of economic activities. For Class 10, it's essential to grasp the sectors of the Indian economy, understand their characteristics, and recognize their importance. This guide will provide detailed notes on the Sectors of the Indian Economy Class 10, using specific long-tail keywords to enhance comprehension.
For more information, visit-www.vavaclasses.com
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
For more information, visit-www.vavaclasses.com
Instructions for Submissions thorugh G- Classroom.pptxJheel Barad
This presentation provides a briefing on how to upload submissions and documents in Google Classroom. It was prepared as part of an orientation for new Sainik School in-service teacher trainees. As a training officer, my goal is to ensure that you are comfortable and proficient with this essential tool for managing assignments and fostering student engagement.
Synthetic Fiber Construction in lab .pptxPavel ( NSTU)
Synthetic fiber production is a fascinating and complex field that blends chemistry, engineering, and environmental science. By understanding these aspects, students can gain a comprehensive view of synthetic fiber production, its impact on society and the environment, and the potential for future innovations. Synthetic fibers play a crucial role in modern society, impacting various aspects of daily life, industry, and the environment. ynthetic fibers are integral to modern life, offering a range of benefits from cost-effectiveness and versatility to innovative applications and performance characteristics. While they pose environmental challenges, ongoing research and development aim to create more sustainable and eco-friendly alternatives. Understanding the importance of synthetic fibers helps in appreciating their role in the economy, industry, and daily life, while also emphasizing the need for sustainable practices and innovation.
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
This is a presentation by Dada Robert in a Your Skill Boost masterclass organised by the Excellence Foundation for South Sudan (EFSS) on Saturday, the 25th and Sunday, the 26th of May 2024.
He discussed the concept of quality improvement, emphasizing its applicability to various aspects of life, including personal, project, and program improvements. He defined quality as doing the right thing at the right time in the right way to achieve the best possible results and discussed the concept of the "gap" between what we know and what we do, and how this gap represents the areas we need to improve. He explained the scientific approach to quality improvement, which involves systematic performance analysis, testing and learning, and implementing change ideas. He also highlighted the importance of client focus and a team approach to quality improvement.
The Art Pastor's Guide to Sabbath | Steve ThomasonSteve Thomason
What is the purpose of the Sabbath Law in the Torah. It is interesting to compare how the context of the law shifts from Exodus to Deuteronomy. Who gets to rest, and why?
Model Attribute Check Company Auto PropertyCeline George
In Odoo, the multi-company feature allows you to manage multiple companies within a single Odoo database instance. Each company can have its own configurations while still sharing common resources such as products, customers, and suppliers.
3. Introduction..
Is it Arthritis or Arthralgia?
Is it Monoarthritis or Polyarthritis ?
Is it Musculoskeletal emergencies ?
4. RED FLAG CONDITIONS
FRACTURE
SEPTIC ARTHRITIS
GOUT/PSEUDOGOUT
NERVE OR VESSEL PROBLEMS
Fever or unexplained weight loss
History of carcinoma
Immuno-supression
Ill health or presence of other medical illness
Night pain
Progressive pain
6. What are the Symptoms?
Unusual
Unusual
Possibly
Weight Loss
Never
Never
Possibly
Fever
Rapid
Slow
Rapid
Loss of Function
Severe
Mild
New and Severe
Fatigue
> 1 hour
15-20 minutes
> 1 hour
Morning Stiffness
No
No
Yes
Joint Redness
No
Yes
Yes
Joint Swelling
No
Yes
Yes
Joint Pain
Chronic Pain
Degenerative
Inflammatory
21. Rheumatoid Arthritis..
Incidence
1-3% of general population
Genetic predisposition
Female to male ratio 3:1
Average age of onset of 40 years
35. Head & Neck Manifestations
Rheumatoid Arthritis may involve the TMJ.
55% Affected
70% with radiographic evidence of TMJ involvement
Juvenile form may lead to Retrognathia
36. Head and Neck Manifestations
Cricoarytenoid joint
Most common cause of cricoarytenoid arthritis
30% patients hoarse
Exertional dyspnea, ear pain, globus
Hoarseness
Rheumatoid nodules, recurrent nerve involvement
Stridor
local/systemic steroids
Conductive Hearing Loss
Ossicular chain involvement
Sensory Neural Hearing Loss
Unexplained
Assoc. with rheumatoid nodules
Cervical spine
Subluxation
38. Laboratory
Rheumatoid Factor
Ig M Antibody against the Fc fragment of Ig G
Not sensitive
80% of RA patients
RF+ patients more likely to have
More severe disease
Extraarticular manifestations
Anti-cyclic citrullinated peptide (Anti-CCP )
Specificity = 90%
Sensitivity = 50-80%
39. RF is not specific for RA.
Other autoimmune disease
Sjogren’s syndrome , Systemic Lupus
Chronic infection
Hep B/C, SBE, Viral, Parasites, TB
Pulmonary inflammation
Sarcoid, IPF, Silicosis, Asbestosis
Malignancy
Healthy – 4% young; 5-25% > age 60
40. Radiography
Periarticular osteopenia
Symmetric joint space loss
Marginal erosions
Absence of productive changes
Best films for diagnosis:
Bilateral Hand Arthritis Series
Bilateral Foot Series
Larger joints may not show erosions early due to
thicker cartilage.
41. Treatment
Aggressive Treatment Early!
Physical therapy, daily exercise, splinting, joint protection
Salicylates, NSAIDS, DMARDs , hydroxychloroquine,
immunosuppressive agents , Steroids
Cyclosporin-A
Prognosis
10-15 yrs of disease
50% fully employed
10% incapacitated
10-20% remission
Persistent active cases more than 1 year likely to lead to joint
deformities.
Periods of activity cases have better prognosis.
Mortality rate 2.5 times than generalpopulation
42. Dental Management
Short dental appointments
Assess if Aspirin or NSAIDs are affecting platelet
function
43. Osteoarthritis?
Most common form of arthritis
Middle-aged to elderly
Gradual pain, worse with use
F= M up to age 55; after 55 F>M
Obesity, history of trauma
Cartilage irregularity
10-20% of these symptomatic
Only small percentage present for help
Joints affected
Hands – DIP, PIP, CMC thumb
Hips, knees, ankles, great toes
Cervical and lumbar spine
48. Gout?
Disease of Monosodium urate crystal deposition in
tissues of and around joints
Adult men, peaks in ages 40’s to 50’s
Urate Overproduction (<10%) vs
Under Excretion (90%)
Three stages:
Asymptomatic hyperuricemia
Acute intermittent gout
Chronic tophaceous gout
Definitive dx by aspiration of fluid
49. Gout?
Onset before 25 should raise the question of unusual form
of gout , specific enzyme defect
A single joint involve in 85-90% of first attack
90% acute attacks in great toe, next in order of frequency
are the ankles, heels, knees, wrists, fingers and elbows
Acute gouty bursitis-- prepatella, olecranon
Chronic
Tophi
50. Septic Arthritis
Septic arthritis is inflammation of a synovial
membrane with purulent effusion into the joint
capsule, usually due to bacterial infection.
It is an emergency- it can destroy a joint extremely
quickly and (v.rarely) lead to sepsis and death
Frequency:
2-10 cases per 100,000 in the general population.
30-70 cases per 100,000 in immunosuppressed/ joint
prosthesis