rheumnemonics

23/05/2024

Heerfordt syndrome is a form of sarcoid. The manifestations are . Uveitis , parotid enlargement and facial palsy

22/05/2024

Musculoskeletal X-ray findings in the hands secondary to sarcoid are usually a lace like pattern appearance. The joint spaces are usually maintained.

22/05/2024

Per the 2019 EULAR/ERA/EDTA update on the management of lupus nephritis the addition of ACEI or ARB ( -Sartans ) is recommended when the proteinuria is > 500 mg

22/05/2024

In a lupus patient a kidney biopsy is needed in cases where: 1) there is an active urine sediment with dysmorphic RBCs 2) increasing Creatinine without any other explanation 3) proteinuria of more than 500 mg

22/05/2024

One of the main tricks to use during rounds as a resident to impress your attending is to make them ask you the question you already know the answer for. For example when you get your next case of lupus nephritis bring up the kidney biopsy result and mention the activity and chronicity index. Activity above 12 ( dozen eggs ) and chronicity above 3 ( tree ) are markers of worse prognosis in lupus nephritis. This will work for both nephrology and rheumatology rotations

21/05/2024

Another way to remember that GPA ( Wegener ) affects upper airways and is associated with C-ANCA is to visualize a guy wearing a ( wig ) with his sinuses affected. He is also wearing a wet suit to remind of the Sea-ANCA ( C-ANCA ) !

21/05/2024

It can be tricky to differentiate between GPA ( granulomatosis with polyangiitis ) and MPA ( microscopic polyangiitis ). Remember that MPA doesn’t usually affect the upper airways as opposed to GPA which usually does. GPA is associated with C ANCA while MPA is associated with P ANCA . They are both small vessel vasculitides.

20/05/2024

Anti synthetase syndrome : Interstitial lung disease, mechanics hands , myositis , symmetric non erosion arthritis , raynauds , fever

20/05/2024

Bone marrow aspirate confirms MAS

20/05/2024

Macrophage activation syndrome is a life threatening condition where there is dysregulation of T lymphocytes and overproduction of cytokines ( a cytokine storm ). The macrophages proliferate and this causes rapidly progressive cytopenia. The phagocytosis happens in the lymph nodes, liver and spleen and hence you can see hepatosolenomegaly and elevated liver enzymes. There is also consumptive coagulopathy and DIC causing low fibrinogen. The low fibrinogen level results in low sed rate. Ferritin is usually more than 10k ( acute phase reactant ). Soluble IL-2 receptor levels are extremely elevated pointing towards dysregulation and over activation of lymphocytes.

19/05/2024

Foods that are good for gout and help lower uric acid

19/05/2024

19/05/2024

Crowned dens syndrome is a form of Chondrocalcinosis affecting the C spine that can cause attacks of headache and neck pain. It is caused by Calcium pyrophosphate deposition around the odontoid in a pattern resembling a crown ( crowned dens ). It can also cause fever and elevated sed rate which makes it mimic GCA and meningitis. Attacks happen in older patients only.

19/05/2024

Chondrocalcinosis ( condor ) is associated with hemochromatosis and iron overload. Remember that the condor sometimes has hook looking claws made of iron. Always screen for hemochromatosis by checking ferritin level with any new diagnoses of CPPD

19/05/2024

One of the classic radiographic patterns seen on a hand XR in chondrocalcinosis ( condor ) aka CPPD is the finding of “ hook osteophytes “ . The joint narrowing pattern usually affects the 3nd and 3rd MCP without affecting the 4th and 5th #

18/05/2024

Chondocalcinosis ( condor ) usually affects older patients and should not be on the DDX of a young patient with joint pain. The most commonly affected joints are the wrist and the knee. On X-rays you can see the calcium deposits usually.

18/05/2024

In chondrocalcinsis aka pseudogout ( fake goat ) the crystals are usually rhomboid and positively birefringent ( blue when parallel )