Clinician's Pearls & Myths in Rheumatology (eBook)

Preface 5
Contents 8
Contributors 11
Chapter 1 18
Rheumatoid Arthritis 18
1.1 Overview of Rheumatoid Arthritis 18
1.1.1 Diagnosis 18
1.1.2 Clinical Features 18
1.1.3 Rheumatoid Arthritis Mimickers 20
1.1.4 Serological Features and Radiology 22
1.1.5 Risk Factors 23
1.1.6 Disease Assessment 23
1.1.7 Treatment 24
1.1.7.1 Treatment Strategy 24
1.1.7.2 Glucocorticoids, Methotrexate, and Conventional DMARDs 24
1.1.7.3 Biologic Agents 26
1.1.8 Co-Morbidities and Adverse Effects 27
1.2 Immunizations in RA 28
References 28
Chapter 2 31
Rheumatoid Vasculitis 31
2.1 Overview of Rheumatoid Vasculitis 31
References 37
Chapter 3 39
Adult-Onset Still’s Disease 39
References 42
Chapter 4 43
Juvenile Idiopathic Arthritis 43
4.1 Overview of Juvenile Idiopathic Arthritis 43
References 47
Chapter 5 49
Monogenic Autoinflammatory Syndromes 49
5.1 Overview of the Monogenic Autoinflammatory Syndromes 49
5.1.1 Familial Mediterranean Fever 49
5.1.2 Tumor Necrosis Factor Receptor-Associated Periodic Syndrome (TRAPS) 54
5.1.3 Hyper Immunoglobulin D and Periodic Fever Syndrome 55
5.1.4 Cryopyrin-Associated Periodic Syndromes 56
5.1.5 Chronic Recurrent Multifocal Osteomyelitis 59
5.1.6 PAPA 60
5.1.7 Cherubism 61
References 62
Chapter 6 66
Juvenile Spondyloarthropathy 66
6.1 Overview 66
References 70
Chapter 7 72
Ankylosing Spondylitis 72
7.1 Overview of Ankylosing Spondylitis 72
References 79
Chapter 8 81
Psoriatic Arthritis 81
8.1 Overview of Psoriatic Arthritis 81
References 84
Chapter 9 86
Reactive Arthritis 86
9.1 Overview of Reactive Arthritis 86
References 89
Chapter 10 90
Systemic Sclerosis (Scleroderma) and Raynaud’s Phenomenon 90
10.1 Overview of Systemic Sclerosis 90
10.1.1 Raynaud’s Phenomenon and Digital Ischemia 90
10.1.2 Diagnosis 93
10.1.3 Autoantibodies and Disease Phenotypes 93
10.1.4 Skin Disease 96
10.1.5 Gastrointestinal Involvement 97
10.1.6 Interstitial Lung Disease 98
10.1.7 Pulmonary Arterial Hypertension 101
10.1.8 Cardiac Disease 103
10.1.9 Scleroderma Renal Crisis 103
10.1.10 Musculoskeletal Manifestations 104
10.1.11 Peripheral Neuropathy in SSc 106
References 106
Chapter 11 109
Nephrogenic Systemic Fibrosis and Other Scleroderma Mimickers 109
11.1 Overview of Nephrogenic Systemic Fibrosis and Other Scleroderma Mimickers 109
11.2 Localized Scleroderma 115
11.3 Morphea 115
11.4 Scleromyxedema 116
11.5 Eosinophilic Fasciitis 117
References 117
Chapter 12 119
Sjögren’s Syndrome 119
12.1 Overview of Sjögren’s Syndrome 119
12.2 Classification and Epidemiology 119
12.3 Pathogenesis 121
12.4 Sicca Features 121
12.4.1 Ocular Manifestations 121
12.4.2 Oral Manifestations 123
12.5 Parotid and Submandibular Involvement 127
12.6 Extraglandular Involvement 128
12.7 Laboratory Findings 134
12.8 Immunological Assays 135
12.9 Differential Diagnosis 136
12.10 Prognosis and Outcome 137
12.11 Systemic Treatment 138
References 138
Chapter 13 143
Systemic Lupus Erythematosus 143
13.1 Overview of Systemic Lupus Erythematosus 143
13.2 Diagnosis 143
13.3 Clinical Features 145
13.4 Cutaneous Lupus 148
13.5 Lupus Nephritis 157
13.6 Central Nervous System Lupus 158
13.7 General Management Points 160
13.8 Treatment 164
References 167
Chapter 14 172
Pediatric Systemic Lupus Erythematosus 172
References 176
Chapter 15 179
Mixed Connective Tissue Disease 179
Overview of Mixed Connective Tissue Disease 179
References 182
Chapter 16 183
The Antiphospholipid Syndrome 183
16.1 Overview of the Antiphospholipid Syndrome 183
16.2 Risk Factors for Thrombosis in APS 185
References 189
Chapter 17 191
Pregnancy in the Rheumatic Diseases 191
17.1 Overview of Pregnancy in the Rheumatic Diseases 191
17.2 Introduction 191
17.3 General Considerations 191
17.4 Medications 193
17.5 Systemic Lupus Erythematosus 195
17.6 Antiphospholipid Syndrome (APS) 197
17.7 Neonatal Lupus Syndromes 197
17.8 Rheumatoid Arthritis 198
17.9 Scleroderma 198
References 199
Chapter 18 201
Infl ammatory Myopathies 201
18.1 Overview of the Infl ammatoryMyopathies 201
18.2 Dermatomyositis Versus Polymyositis 201
18.3 Skin Disease 201
18.4 Muscle Enzymes 203
18.5 Myositis-Specifi c Autoantibodies 204
18.6 Imaging 207
18.7 Inclusion Body Myositis 208
18.8 Treatment 208
References 209
Chapter 19 210
Juvenile Dermatomyositis 210
19.1 Overview of Juvenile Myositis 210
References 217
Chapter 20 219
Vasculitic Neuropathy 219
20.1 Vasculitic Neuropathy Overview 219
20.2 Presentation 219
20.3 Diagnosis: Electrodiagnostic Studies and Biopsy 222
20.4 Pathophysiology 224
20.5 Treatment 225
References 226
Chapter 21 227
Pediatric Vasculitis 227
Overview 227
21.1 Kawasaki Disease 227
21.2 Henoch–Schönlein Purpura 231
21.3 Polyarteritis Nodosa 235
References 237
Chapter 22 239
Behçet’s Syndrome 239
22.1 Disease Overview 239
References 245
Chapter 23 247
The Churg–Strauss Syndrome 247
23.1 Overview of the Churg–Strauss Syndrome 247
References 251
Chapter 24 253
ANCA-Associated Vasculitis 253
24.1 Overview of ANCA-Associated Vasculitis 253
24.2 Epidemiology 253
24.3 Nose, Sinuses, and Ears 253
24.4 Subglottic Stenosis 256
24.5 Mouth 259
24.6 Eyes 260
24.7 Lungs 261
24.8 Kidneys 264
24.9 Bladder 267
24.10 Skin 267
24.11 Joints 267
24.12 Peripheral and Cranial Nerves 267
24.13 Central Nervous System 268
24.14 Spleen 269
24.15 ANCA 269
24.16 Treatment and Course 270
References 273
Chapter 25 276
Cryoglobulinemia 276
25.1 Overview of Cryoglobulinemia 276
References 280
Chapter 26 281
Polyarteritis Nodosa 281
13.1 Overview of Polyarteritis Nodosa 281
References 289
Chapter 27 291
Giant Cell Arteritis and Polymyalgia Rheumatica 291
Overview of Giant Cell Arteritis 291
27.1 Symptoms and Signs 291
27.2 Laboratory Testing 297
27.3 Imaging 298
27.4 Temporal Artery Biopsy 300
27.5 Pathology 302
27.6 Treatment 305
27.7 Outcomes 307
References 309
Chapter 28 311
Takayasu’s Arteritis 311
Overview of Takayasu’s Arteritis 311
References 316
Chapter 29 317
Primary Angiitis of the Central Nervous System and Reversible Cerebral Vasoconstriction Syndromes 317
29.1 Overview of Primary Angiitis of the Central Nervous System 317
29.2 Overview of Reversible Cerebral Vasoconstriction Syndromes 319
References 322
Chapter 30 323
Thromboangiitis Obliterans (Buerger’s Disease) 323
30.1 Overview of Thromboangiitis Obliterans (Buerger’s Disease) 323
References 329
Chapter 31 330
Less Common Forms of Vasculitis 330
31.1 Cogan’s Syndrome 330
31.1.1 Overview of Cogan’s Syndrome 330
31.2 Erythema Elevatum Diutinum 332
31.2.1 Overview of Erythema Elevatum Diutinum 332
31.3 Urticarial Vasculitis 333
31.3.1 Overview of Urticarial Vasculitis 333
References 338
Chapter 32 339
Relapsing Polychondritis 339
32.1 Overview of Relapsing Polychondritis 339
32.2 Ear Involvement 339
References 343
Chapter 33 344
Fibromyalgia 344
33.1 Overview of Fibromyalgia 344
References 351
Chapter 34 353
The Clinical Features of Gout 353
34.1 Overview of the Clinical Features of Gout 353
References 356
Chapter 35 357
Gout Epidemiology 357
35.1 Overview of Gout Epidemiology 357
References 360
Chapter 36 362
Gout Treatment 362
36.1 Overview of the Treatment of Gout 362
References 368
Chapter 37 369
Calcium Pyrophosphate Dihydrate (CPPD) Crystal Deposition Disease 369
37.1 Overview of CPPD 369
37.2 Symptoms and Signs 369
37.3 Diagnosis 372
37.4 Epidemiology 373
37.5 Pathophysiology 374
37.6 Treatment and Outcomes 375
References 375
Chapter 38 377
Infl ammatory Eye Disease 377
38.1 Overview of Infl ammatory Eye Disease 377
References 383
Chapter 39 385
Immune-Mediated Inner Ear Disease 385
39.1 Overview of Immune-Mediated Inner Ear Disease 385
39.2 Defi nition 385
39.3 The Clinical History 387
39.4 Physical Findings 387
39.5 Auditory and Vestibular Tests 388
39.6 Differential Diagnosis 389
39.7 Treatment 391
References 391
Chapter 40 393
Osteoporosis 393
40.1 Overview of Osteoporosis 393
40.2 Osteoporosis Epidemiology 393
40.3 Osteoporosis Diagnosis: Bone Mass Measurement 395
40.4 Osteoporosis Prevention: Calcium and Sodium Effects 396
40.5 Osteoporosis Prevention: Vitamin D 398
40.6 Osteoporosis Treatment: General Considerations 399
40.7 Osteoporosis Treatment: Hormone Replacement Therapy 400
40.8 Osteoporosis Treatment: Bisphosphonates 400
References 401
Chapter 41 405
Paget’s Disease of Bone 405
41.1 Overview of Paget’s Disease 405
References 407
Chapter 42 409
Sarcoidosis 409
42.1 Overview of Sarcoidosis 409
References 418
Chapter 43 421
Osteoarthritis 421
43.1 Overview for Osteoarthritis 421
References 430
Chapter 45 446
Low Back and Neck Pain 446
45.1 Overview 446
45.2 General Considerations 446
45.3 History and Physical Examination 447
45.4 Imaging 449
45.5 Disc Herniation 450
45.6 Spinal Stenosis 451
45.7 Spondylolisthesis 452
45.8 Miscellaneous but Important Causes of Low Back Pain 453
45.9 Other Approaches to Evaluation and Treatment 453
45.10 Surgery 454
45.11 Neck Pain 455
References 457
Chapter 46 459
Amyloidosis 459
46.1 Overview of Amyloidosis 459
References 464
Chapter 47 465
The Ehlers-Danlos Syndrome 465
47.1 Overview of the Ehlers-Danlos Syndrome 465
47.2 Skin Care 471
47.3 Bruising 471
47.4 Joint Protection 471
47.5 Emotional Support 471
References 472
Chapter 48 474
Osteonecrosis 474
48.1 Overview of Osteonecrosis 474
Reference 480
Index 481