انت هنا الان : شبكة جامعة بابل > موقع الكلية > نظام التعليم الالكتروني > مشاهدة المحاضرة
الكلية كلية الطب
القسم الباطنية
المرحلة 6
أستاذ المادة علي محمد حسين خلف القزاز
6/5/2011 4:47:14 AM
Rheumatic manifestation of systemic diseases –hypertrophic osteoarthropathy HOA Long bone perostitis with clubbing of fingers and toes ,90%with lung CA,other disease like lung fibrosis ,cirrhosis and another tumors Mostly involved long bones ,distal ends ,pathogenesis unknown but may due to increase the blood flow in that area ,it result in pain and swelling but no inflammation Leukemia and lymphoma : They may simulate various rheumatic disease by synovitis and bone pain from direct invasion or bone marrow expansion 6% of adult patients with leukemia present with rheumatic manifestation before diagnosis by three months, present with Symmetrical arthritis and oligoarthritis . In children 60% of acute leukemia present with mono or poly arthritis . In lymphoma arthritis rare but bone pain is common The treatment directed to the disease itself . Hemophilia: Hemoarthosis most common complication of either type A,FACTOR 8,deficiency or type B FACTOR 9 deficiency It occur in 2\3 of patients ,may occur spontaneously or with minor trauma and it depend of it severity on level of deficiency Chronic arthropathy with persistent arthritis may occur result degenerative arthritis disease. Treatment depend on replacement therapy ,local ice, local corticosteroid ,rest later physiotherapy . Sickle cell disease: SS, S Talasemia,SC, SD,all result joints problem ,painful crisis ,arthropathy ,dactylitis ,osteonecrosis,gout, and osteomylitis painful arthritis affect big joints ,the synoival fluid is non inflammatory with increase the incidence of septic arthritis ,salmonella most frequent isolated organism, Thalasemia : B thalasemia major result in osteoporosis, pathological fracture, and epiphysis deformities ,minor type associated with non inflammatory arthritis . Multiple myloma and amylodosis: MM is plasma cell dyscerasias result in bone pain from lytic bone lesion, and pathological fracture with osteoporosis ,amyloid joint infiltration produce symmetrical small joints polyarthritis simulate RA. Some time infiltrate shoulder with amyloid deposit result in soft tissue deformities [shoulder pad sign],the diagnosis is made by demonstrate of the apple green birefringent fluorescence on congo red staining of abdominal fat this is primary amylodosis. The AA type secondary form result from chronic inflammatory disease like RA,IBD, LEPROSY ,TB,OSTEOMYLITIS.they lead to arthralgia the diagnosis made by biopsy of the involved organ , and the treatment directed to the under line disease. B2 microglobemia[B2M]associated amylodsis occur in patients with long standing hemodialysis CRF ,present with C.T.S,flexor tendons deposit in hands and shoulder result from B2 microgloin deposit the treatment supportive unless transplant is done. Whipple disease: Arthritis occur in 60%-90%usually intermittent, migratory and oilgarthritis last few hours to days with spontaneous remission some time only arthralgia synovial fluid is inflammatory with increase mono nuclear cells ,it treated with antibiotics therapy [tetracycline] result in complete remission with one week to one month ,it caused by organism trophenyma whippleii. Hemochromatosis Arthritis result from iron deposition disease with increase iron absorption ,it result in symmetrical arthritis of 2nd-3rd MCP occur in 50% of patients ,X-ray show same change of osteoarthritis with presence of condrocalcinosis definite diagnosis made by identification of mutant gene sequence in the peripheral blood. Endocrine diseases : DM- C.T.S Adhesive capsulitis Charcot joint Syndromes of limited joints mobility [cheiroarthropathy] DM arthropathy Diabetic muscle infarction Hypothyroidism: Proximal myopathy Arthralgia Joint effusion C.T.S Chondroclacinosis Hyperthyroidism : Myopathy Osteoporosis Thyroid acropchy Hyperparathyroidism : Mypathy Arthralgia Erosive arthritis Chondrocalcinosis Hypoparathyrodism : Muscles cramps Soft tissue calcification and spondyloarthropathy Acromegly : C.T.S Myopathy Raynauds phenomenon Back pain Premature osteoarthritis Cushing : Myopathy Osteoporosis A vascular necrosis
المادة المعروضة اعلاه هي مدخل الى المحاضرة المرفوعة بواسطة استاذ(ة) المادة . وقد تبدو لك غير متكاملة . حيث يضع استاذ المادة في بعض الاحيان فقط الجزء الاول من المحاضرة من اجل الاطلاع على ما ستقوم بتحميله لاحقا . في نظام التعليم الالكتروني نوفر هذه الخدمة لكي نبقيك على اطلاع حول محتوى الملف الذي ستقوم بتحميله .
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