This document provides an overview of how to approach a patient with arthritis. It describes common symptoms of arthritis and how to differentiate between inflammatory and non-inflammatory types based on history, physical exam findings, pattern of joint involvement, onset and duration of symptoms, and additional features. It discusses specific types of arthritis like osteoarthritis, gout, pseudogout, septic arthritis, rheumatoid arthritis, seronegative spondyloarthritides, and others. It provides guidance on diagnostic tests, imaging, and treatment approaches for different arthritis conditions.
An apt yet detailed description of Polyarthritis for undergraduate level with basic definitions, classification, concept, clinical features along with descriptive images, diagnosis & assessment with distinguishing features along with differential diagnosis.
Crystal arthropathies gout & pseudogoutShinjan Patra
Gout is one of the most dangerous underrated acute emergency in rheumatological diseases. CPPD disease is an another entity which is very much under-diagnosed in respect t OA
An apt yet detailed description of Polyarthritis for undergraduate level with basic definitions, classification, concept, clinical features along with descriptive images, diagnosis & assessment with distinguishing features along with differential diagnosis.
Crystal arthropathies gout & pseudogoutShinjan Patra
Gout is one of the most dangerous underrated acute emergency in rheumatological diseases. CPPD disease is an another entity which is very much under-diagnosed in respect t OA
This presentation will give a brief idea on proximal myopathy, causes, clinical presentation, history and physical examination, investigations to diagnose the disease easily.
It will be more helpful to medical students.
This presentation looks at some of the common conditions that can present with hemiplegia. Stroke is the commonest, however, there are several other causes that need to be considered in a patient presenting with hemiplegia.
Edema is defined and its mechanism explained with reference to the Starling's forces. The causes of localized edema and anasarca discussed.
In history taking, the site and distribution of edema, its duration, association with pain, variability, systemic illness, drug intake, trauma, radiation discussed.
The local and systemic examination described. The approach to investigation including lab tests and imaging explained.
Finally, management is discussed in short.
This presentation will give a brief idea on proximal myopathy, causes, clinical presentation, history and physical examination, investigations to diagnose the disease easily.
It will be more helpful to medical students.
This presentation looks at some of the common conditions that can present with hemiplegia. Stroke is the commonest, however, there are several other causes that need to be considered in a patient presenting with hemiplegia.
Edema is defined and its mechanism explained with reference to the Starling's forces. The causes of localized edema and anasarca discussed.
In history taking, the site and distribution of edema, its duration, association with pain, variability, systemic illness, drug intake, trauma, radiation discussed.
The local and systemic examination described. The approach to investigation including lab tests and imaging explained.
Finally, management is discussed in short.
8 July is World Hepatitis Day
World Hepatitis Day, 28 July, is an opportunity to step up national and international efforts on hepatitis, encourage actions and engagement by individuals, partners and the public and highlight the need for a greater global response as outlined in the WHO's Global hepatitis report of 2017.
The date of 28 July was chosen because it is the birthday of Nobel-prize winning scientist Dr Baruch Blumberg, who discovered hepatitis B virus (HBV) and developed a diagnostic test and vaccine for the virus.
Low coverage of testing and treatment is the most important gap to be addressed in order to achieve the global elimination goals by 2030.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journey
Approach to arthritis
1. APPROACH TO ARTHRITIS
Guide : Dr. Sanjay Dubey Sir
Candidate : Dr. Sagar Dagdiya
Dept. Of Medicine, M.G.M.M.C. Indore
2. Arthritis is an inflammatory process affecting a
joint/joints and may present with following symptoms:
1. Pain
2. Stiffness
3. Swelling
4. Limitation of Movement
5. Weakness
6. Fatigue
3. History and Physical
Examination
Periarticular
Bursitis/Tendinitis/Ligame
nt Strain/Bone Pathology
Articular
Morning stiffness/Warmth/Erythema
Non
Inflammatory
Osteoarthritis
CTD
Inflammatory
Monoarticular
Infection/Gout/
Pseudogout
Oligoarticular
AS/Reiter'/Reactive
IBD/Psoriatic
Polyarticular
RA/SLE/
Psoriatic/CTD
Absent Present
4. Musculoskeletal Evaluation
Articular
1.Symptoms present throughout the range
of movement
2. Joint Instability
3. Swelling
4. Presence of deformity
Non Articular
1. Symptoms present at a particular point in
the range of movement
2. Joint instability absent
3. Swelling absent
4. Deformity absent
5. Articular
-Pain both at rest and during
motion
-Pain worse at rest
-Stiffness typically lasts for >30mins
-Joint swelling is related to synovial
hypertrophy, synovial effusion &/or
inflammation of periarticular
structures
-Limited range of movement
-Presence of Warmth and Erythema
-Due to alterations in the structure
or mechanics of the joint
-Pain mainly during motion &
improves quickly on rest.
-Stiffness not more 15-30 minutes.
-Swelling results due to formation
of osteophytes or due to soft
tissue swelling related to synovial
cysts, thickening or effusion.
Traumatic Degenerative Mechanical
Inflammatory Non inflammatory
6.
7. D/D on the basis of ONSET OF
SYMPTOMS
Abruptly over few
hours to days
Trauma
Crystal arthritis
Septic Arthritis
Insidiously over
weeks to months
Rheumatoid Arthritis
Osteoarthritis
Seronegative
Spondyloarthropathies
Chronic Gout
8. D/D on the basis of
DURATION OF SYMPTOMS
ACUTE, i.e. , <6weeks CHRONIC, i.e. , >6weeks
Trauma
Juxta-Articular
Septic Arthritis
Reactive Arthritis
Gout
Rheumatic Fever
Rheumatoid Arthritis
SLE
Spondyloarthropathies
OA
Haemochromatosis
9. D/D on the basis of PATTERN OF
JOINT INVOLVEMENT
Migratory Additive/Simultaneous Intermittent
Acute Rheumatic Fever
Disseminated Gonococcal
Infection
Viral Arthritis
RA
SLE
Spondyloarthritids
Gout
Viral Arthritis
Lymes Disease
10. Distribution of affected joints :
DIP involved in Psoriatic Arthritis, OA and Gout.
Axial Skeleton is involved in AS, especially Lumbar Spine
and Sacroiliac Joint.
Weight bearing joints e.g. Knee and Hip Joints are
especially involved in OA.
1st Metatarsophalengeal Joint is usually first involved in
Gout.
Heal Pain due to inflammation at the insertion of Achilles
Tendon &/or Plantar Facia is typically seen in
Spondyloarthritids.
11. 6. Extra-Articular Manifestations (Constitutional
Symptoms) :
Presence of Skin, Nail & Mucous Membrane Lesions may
points to the possibility of SLE, Psoriatic Arthritis,
Scleroderma.
Arthritis of IBD may present with the features of Crohns
Disease or Ulcerative Colitis.
Presence of Urethritis, Conjunctivitis and Arthritis may
points to the possibility of Reiter Syndrome that usually
follows after non-specific GI or GU Infections.
12. DIAGNOSIS TYPE ADDITIONAL
FEATURES
LAB & IMAGING
OA Noninflammatory,
mono/oligo/poly-
articular
Bone Spurs; knee, hip,
PIP, DIP, 1st MTP, 1st CMC.
Normal ESR/CRP,
Osteophytes, Bone
Sclerosis
Gout Inflammatory,
mono/oligo/poly-
articular
Tophi; Acute attacks f/b
spontaneous resolution
Raised UA Levels, + UA Crystals
in joint fluid, Raised ESR/CRP,
Erosions with overhanging
borders
Pseudogout Inflammatory,
mono/oligo/poly-
articular
Acute/Chronic Attacks Raised ESR/CRP Levels, +
CPPD Crystals in joint fluid
Septic Joint Inflammatory
Monoarticular, rerely
Polyarticular
Sepsis, Fever Raised ESR/CRP, + Cultures,
Leucocytosis,
Immunosuppressed
RA Inflammatory
Polyarticular
Extraarticular
Manifestations, DIP
never Involved
Periarticular Osteoporosis, +RF &
Anti-CCP, Raised ESR/CRP
Pso A. Inflammatory Oligo or
Polyarticular
Psoriatic skin rash,
Asymmetric SI Joint
Involvement,
Syndesmophytes
Erosions, Ankylosis
AS Inflammatory Bamboo Spine, Symmetric
SI Joint Involvement,
Ankylosis, Trolly Track Sign,
Dagger Sign
16. Infectious Arthritis
1.Gonococcal Arthritis (50% of all septic arthritis in sexually active
young adults) presents as migratory / additive polyarthralgias f/b
tenosynovitis or arthritis of wrist, ankle or knee with vesiculopustular
skin rashes on extremities.
2. Non Gonococcal Infectious Arthritis ( due mainly to Staphylococcus
Aureus >> Streptococcus species, Gram –ve organisms are rare &
typically seen in cases with IV drug abusers, neutropenia or post
operative cases) usually presents as fever with acute monoarticular
arthritis, though sometimes multiple joints may be involved.
17. Tubercular Arthritis
Monoarticular & most commonly affects Spine and other weight bearing
joints, 10-35% of extra pulmonary TB (hematogenous spread)
Active focus forms in metaphysis(in children) or epiphysis(in adults).
Sometimes the synovium is involved first to develop low grade Synovitis.
Localized osteoporosis is the first radiological sign of active disease.
Synovial Fluid Analysis :
1. Lymphocytes>PMN with High ADA levels
2. PCR analysis is faster and more sensitive(85-95%) but less
specific(70%)
3. The gold standard for diagnosis is synovial biopsy with positive
results in 90% of cases.
4. Culture is positive in 80% of cases.
Sometimes a dry tap can also be seen and in such cases sterile water lavage
can be helpful.
18. Variables Pyogenic Arthritis Tubercular Arthritis
Radiological Progression Rapid, Short History Slow, Insidious Onset
Marginal Erosions Early Late
Joint Space Narrowing Early Late
Periosteitis Common Rare
Sclerosis Present +/-
Osteoporosis Minimal Marked
Ankylosis Bony (common) Fibrous, except in Spine where
Bony
19. Crystal Induced Arthritis
Primary Gouty Arthritis : Mainly due to
underexcretion of uric acid (90%) rather than its
overproduction.
Pseudogout : Due to Calcium Pyrophosphate
Dihydrate Crystals deposited in bone and cartilage are
released in synovial fluid inducing acute inflammation (r/f
older age, advanced OA, neuropathic joint,
hyperparathyroidism, hemochromatosis, DM or
Hypothyroidism).
21. Rheumatoid Arthritis
-Peak incidence 4-6th Decade.
-Symmetric inflammatory polyarthritis with extra-
articular manifestations like Rheumatoid Nodules,
Pulmonary Fibrosis, Serositis, Vasculitis & +ve Serum RF.
-RF may be +ve in about 75-80% and Anti-CCP Ab may
be +ve in 50-60% of patients, Anti-CCP Ab more specific
(>95%).
-RF may be +ve in chronic infections & other CTD’s.
-Felty Syndrome : Triad of RA + Spleenomegaly +
Granulocytopenia.
- Z Deformity, Swan Neck Deformity, Boutonniere
Deformity.
23. Osteoarthritis or Degenerative Joint
Disease
-Most common form of Arthritis (Uncommon before 40yrs of age).
-Prevalence & Impairment increases with age.
-Characterised by deterioration of Articular Surface with
Subsequent formation of reactive new bone at the Articular
Surface & Decreased Joint Space.
-Joints commonly involved are Knee, Hip, PIP(Bouchard’s),
DIP(Haberden’s), 1st CMC.
-Joints spared are Wrist, MCP(except Thumb), Elbow, Ankle.
-Pathophysiology : Abnormal Cartilage repair & remodelling.
(Chondrocytes release Proteolytic Enzymes that destroy Cartilage leading to Subchondral
Sclerosis and Cysts with Marginal Osteophytes.)
28. Ankylosing Spondylitis : Sacroiliatis, Syndesmophytes,
Squaring of Vertebrae Bamboo Spine, Dagger Sign, Trolley
Track Sign on X-Ray, Pain improves with Exercise and
worsens on Rest.
Psoriatic Arthritis : Psoriatic skin changes seen in 60-70%
of cases whereas Nail changes seen in 90% of cases.
Arthritis Mutilans and Pencil in Cup Deformity.
29. Reactive Arthritis :
Triad of Urethritis, Conjunctivitis & Arthritis.
Ocassionally preceded by GI or GU infections.
Syndrome is transient lasting for 1 to several
months but chronic arthritis may develop in 4-19%
of cases.
30.
31.
32. Soft Tissue Rheumatism
-Most common cause of Musculo-Skeletal Pain.
-Mostly associated with Fibromyalgia.
-Characterised by Bursitis, tendonitis or tenosynovitis.
-Improves with Local Steroid Injections.
33. Polymyalgia Rheumatica(PMR)
-Presents in elderly males as proximal limb girdle pain,
morning stiffness and constitutional symptoms.
-Associated with Temporal Arteritis(TA) in 40% of cases.
-Patients with TA presents with headache, scalp
tenderness, jaw & tongue claudication, vision
disturbances and stroke.
-PMR : Elevated ESR
-TA : Elevated ESR (often >100mm/hr.)