Muscle and Bone Problems
Gout
- This happens when you have too much uric acid in your blood.
- It causes painful swelling, usually in the big toe.
- You might see small bumps under the skin.
- Symptoms: Joint pain, swelling, redness, and tenderness.
- Diagnosis: Doctors can check your blood for high uric acid. They can also take fluid from the joint and look for needle-shaped crystals.
- Treatment: For sudden attacks, use pain medicine (NSAIDs). For long-term treatment, medicines like allopurinol or febuxostat can help.
Pseudogout
- This is similar to gout but caused by different crystals. The crystals are rhomboid-shaped.
Rheumatoid Arthritis (RA)
- This makes your joints stiff, especially in the morning.
- It usually affects the same joints on both sides of your body, like fingers.
- Symptoms: Stiff fingers in the morning.
- Diagnosis: Blood tests can show “Anti CCP antibody”.
- Treatment: Medicines called DMARDs (like methotrexate) are used.
- Complications:
- Felty Syndrome: RA with a big spleen and low white blood cells.
- Caplan Syndrome: RA with lung problems.
Osteoarthritis
- This causes joint pain and stiffness that gets worse with activity and better with rest.
- It usually affects different joints on each side, like fingers, elbows, and knees.
- Symptoms: Joint pain and stiffness.
- Diagnosis: X-rays can show joint space narrowing and bone spurs.
Behcet Syndrome
- This causes sores in the mouth and genitals, and eye problems.
Septic Arthritis
- This is a joint infection, usually from bacteria like Staph. aureus.
- Symptoms: Joint pain, high fever, chills, redness, and tenderness.
- Diagnosis: Doctors take fluid from the joint to check for bacteria.
- Treatment: Antibiotics like ceftriaxone and vancomycin.
Bone Tumors
- Giant cell tumor: Found in the ends of bones (epiphysis).
- Osteosarcoma: Found in the middle part of long bones (metaphysis). Common in 10-20 year olds and 40-60 year olds. X-rays can show a “sunburst appearance”.
- Ewing sarcoma: Found in the shaft of long bones (diaphysis).
Seronegative Arthritis (Arthritis without certain antibodies)
Ankylosing Spondylitis
- This causes swelling and stiffness in the lower back and pelvis.
- Symptoms: Inflammation in the sacroiliac joint.
- Complications: Eye inflammation (uveitis) and heart problems.
- Diagnosis: X-rays can show fusion of joints and “bamboo spine”.
- Treatment: Pain relievers (NSAIDs) and muscle relaxants.
Reactive Arthritis (Reiter Syndrome)
- This can cause eye redness (conjunctivitis), joint pain (arthritis), and problems with urination (urethritis).
Psoriatic Arthritis
- This affects joints, often in the fingers and toes.
- X-rays can show a “pencil in cup deformity”.
Inflammatory Bowel Disease (IBD) related arthritis
- Can cause a type of back stiffness similar to ankylosing spondylitis.
Autoimmune Diseases (When Your Body Attacks Itself)
Polymyositis
- Causes muscle weakness and inflammation.
- Symptoms: Difficulty standing.
- Diagnosis: Muscle biopsy.
- Treatment: Steroids.
Dermatomyositis
- Similar to polymyositis but also causes skin rashes, especially on eyelids, knuckles, and shoulders.
- Diagnosis: Muscle biopsy.
- Treatment: Steroids.
Systemic Lupus Erythematosus (SLE)
- A disease that can affect many parts of the body.
- More common in younger women.
- Symptoms: Butterfly-shaped rash on the face, joint pain, fatigue, sun sensitivity, and problems with blood, kidneys, or brain.
- Diagnosis: Blood tests show ANA (sensitive) and anti-dsDNA (specific) antibodies.
- Drug-induced SLE: Caused by certain medicines, and shows anti-histone antibodies.
Systemic Sclerosis (Scleroderma)
- Causes skin hardening due to too much collagen.
- Limited type: Affects skin, but not mucous membranes. Symptoms include calcium deposits, Raynaud’s phenomenon (fingers change color in cold), problems with food going down, stiff fingers, and tiny red spots on the skin.
- Diffuse type: Affects mucous membranes, kidneys, and lungs.
- Diagnosis: Anti-Centromere antibody for limited type, Anti-Scl70 antibody for diffuse type.
- Treatment: ACE inhibitors for kidney problems.
Sjogren’s Syndrome
- An autoimmune disease that dries out glands, like tear and salivary glands.
- Symptoms: Dry eyes, dry mouth, dry vagina.
- Diagnosis: Blood tests show Anti-Ro(SSA) and Anti-La(SSB) antibodies. Schirmer test measures tear production.
- Treatment: Artificial tears and pilocarpine.