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يلا نكمل لل10

The wrist have many joint but count as a single joint

Heberden’s node

وين تصير؟
Osteoarthritis
وين تصير اكثر شيء؟
1-distal interphalangeal joint
2-proximal interphalangeal joint
3-metacarpal phalangeal joint
4-Carpometacarpal joint
بيها criteria
اسمها؟
ACR criteria
يصير بيها؟
Hand pain+ aching or stiffness
+three of the following
•hard tissue enlargement of at least two of 10 selected joints
•hard tissue enlargements of at least two DIPJs
•Swelling of fewer than three MCPJs
•deformity of at least one of 10 selected joints

الحالة very commonوsymmetrical

Degenerative joint disorders?

Haemochromatosis(small joint and large joint)
Acromegally (large joint and spine

ثنينهم rare

Disease that seronegative spondyloarthritis ?
•psoriasis arthritis
•reactive arthritis
•ankylosing spondylitis
•enteropathic arthopathy

كلهن نلاكهن بلlarge joint اكثر
ويكون asymmetrical
ويأثر بالlower اكثر من upper limbs
وهم ياثر بالspine

Rheumatoid arthritis
-symmetrical
-small and large joint
-upper and lower limb

Psoriatic arthritis
(Seronegative)
-asymmetrical
-large>small joints
-lower>upper
-have dactylitis(تختلف)

هسه خلصنا pain

اهم شيء بالمحاضرة

About synovial fluid amount

Normal

200cells/mm3 or less

Non inflammatory arthropathies

Up to 2000cells/mm3

Non infectious inflammatory arthropathies

2000-100000 celss/mm3

1-autoimmune arthropathies

2000-30000 cells/mm3

2-Rheumatoid arthritis

2000-50000cells/m
If more is not RA

3-Gout

30000 or higher
Average 50000 to 75000 cells/mm3+ crystal

Septic arthritis

100000 cells/mm3
Treat it by empirically for septic joint until microbiolgic data exclude infection
اذا اقل من 100 الف ماكو infection

اكو شغلة طفرتها خل احجي عنها وراها نكمل

Stiffness is common with arthritis
يختلف بين مريض لمريض
وحيوصفه المريض ب
Pain,soreness,fatiuge,limitation of movement
واختصاص الرماتو شيوصفة؟
Discomfort and limitations on attempted movement of joint after peroid of inactivity
بحيث يسموا

Gel phenomenon

هاي ظاهرة تصير ورا ساعة او اكثر من عدم حركة المفصل
والsevirty تعتمد حسب وقت عدم حركة المفصل

Done✅

استراحة لل10 وربع

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