Rheumatoid nodules, a common complication of rheumatoid arthritis, not only may result in pain and disfigurement but also may lead to compressive neuropathy.

Slides:

Advertisements

Similar presentations

Two examples of incised wounds

Advertisements

Knee mobilization with movement for flexion. A

Schematic drawing of a Nissl-stained motor neuron

Reproduced with permission from British Journal of Sports Medicine

Debulking and tissue reduction

Radial nerve palsy creates an inability to extend the wrist and fingers. A) Wrist drop occurs with radial nerve palsy. B) With use of a wrist extension.

Herpes zoster (shingles) involving the L2 nerve root in a 63-year-old woman presenting with low back and groin pain. Calamine lotion has been applied to.

Peripheral intravenous cannulation. A

(A) Lateral view of the vertebral column, showing the levels at which the various nerve roots exit; nerves exit above their numbered vertebral body in.

Epidural lysis of adhesions

Aphthous ulcers in Crohn disease

A: Location of the mental and incisive nerves

Reproduced from Hadzic A

Reproduced from Hadzic A

The importance of surface tension

Follicular lymphoma. The normal nodal architecture is effaced by nodular expansions of tumor cells. Nodules vary in size and contain predominantly small.

Wong-Baker FACES pain scale (Wong-Baker FACES Foundation (2015)

A widely displaced fracture of the distal radius

Pathophysiology of esophageal reflux disease

Syringomyelia (the presence of a cavity in the spinal cord due to breakdown of gliomatous new formations, presenting clinically with pain and paresthesias.

Syringomyelia (the presence of a cavity in the spinal cord due to breakdown of gliomatous new formations, presenting clinically with pain and paresthesias.

The cycle of injury and reinjury resulting from rotator cuff impingement. Source: Chapter 3. Sports Medicine, Current Diagnosis & Treatment in Orthopedics,

Iron deficiency anemia. (Peripheral blood, 50 ×

Rheumatoid arthritis. Frontal view of the hand in a 59-year-old female demonstrating end-stage rheumatoid arthritis of the hand and wrist with marked osteoporosis.

Astronauts on the space station exercise with straps holding them down on specialized treadmill surfaces. Photo courtesy of NASA. Source: The Biomechanics.

Nine patterns of inflammatory skin disease. (See also Table 8–1.)

Forearm support for sustained work at the computer.

Equipment for continuous sciatic block

Using the prosthesis as an assisting hand

A 39-year-old woman sustained a traumatic shoulder dislocation with a lower brachial plexus injury. She was initially treated with upper arm immobilization.

Testing the radial nerve. (A) Sensory distribution

The LifeStat system is an example of a piston compression device

C. Nerve conduction studies demonstrate changes characteristic of an axonal neuropathy. When the ulnar nerve is stimulated above the elbow or at the wrist,

Psoriatic arthritis. Photograph of the hand (A) demonstrates diffuse fusiform swelling and erythema of the second digit, called a “sausage digit.” Radiograph.

During carpometacarpal (CMC) abduction, the examiner uses one hand to stabilize the subject's second metacarpal. Her other hand grasps the subject's first.

Internal hemorrhoids. (Used, with permission, from John Cello, MD.)

(A) Lateral view of the vertebral column, showing the levels at which the various nerve roots exit; nerves exit above their numbered vertebral body in.

Left partial third nerve palsy with ptosis (A), reduced adduction (B), elevation (C), and depression (D) but normal abduction (E) of the left eye. Source:

Eosinophilic pneumonia

How to position the patient and the x-ray beam for a flexed knee weight-bearing PA view. It is difficult to put the film flat against the back of the knee.

Cochlear implant. (A) A multichannel cochlear implant processor, microphone, and magnet coil. (B) Cochlear implant internal device electrode array and.

REPRODUCED WITH PERMISSION OF BRITISH JOURNAL OF SPORTS MEDICINE

In this case of tinea incognito, the patient applied a topical corticosteroid, previously prescribed for atopic dermatitis, to an undiagnosed ringworm.

Pulmonary sarcoidosis

CT myelogram demonstrates severe spinal stenosis at L3-L4 along with bilateral facet arthropathy (black arrows). Source: Chapter 4. Disorders, Diseases,

A close relationship exists between heterotopic nodules and cortical regions in bilateral PNH, with an epileptogenic network including both structures.

A standard epidural order form.

FROM VICENZINO ET AL39 Source: Elbow and arm pain, Brukner & Khan’s Clinical Sports Medicine: Injuries, Volume 1, 5e Citation: Brukner P, Clarsen B, Cook.

Lead implantation for peripheral nerve stimulation (PNS)

Primary ocular herpes simplex virus infection

A–E. The resisted isometric component of STT testing for the elbow

Sciatic nerve at the level of popliteal fossa. Hematoxylin-eosin

Prostate cancer. Classically, prostate cancer is described as hypoechoic nodules in the peripheral zone as seen here. In reality, prostate cancer is often.

Juvenile rheumatoid arthritis Faint erythematous, urticarial plaques on the torso of a child. Source: Section 17. Autoimmune Connective Tissue Diseases,

Types of hearing aids. Left, in-the-ear; center, behind the ear; right, in-the-canal. Source: Assessment and Management of Auditory Disorders and Tinnitus,

Parasacral sciatic block: Shown is the course of the catheter (1) This image is a PA (posterior-anterior) view and visualization of the injectate around.

Sciatic nerve stimulation: motor response of the common peroneal or tibial nerves indicate proper localization of the sciatic nerve. Source: Chapter 37.

Internal hemorrhoids. (Used, with permission, from John Cello, MD.)

This infant developed typical arcuate lesions on the face

Treatment of tight piriformis muscle (a) Soft tissue therapy—piriformis. Sustained longitudinal pressure to the belly of the piriformis muscle, initially.

A. Use of athletic tape to make an extension block for the wrist. B

Keratoderma blennorrhagica of the soles due to reactive arthritis (Reiter syndrome). (From Susan Lindsley, Public Health Image Library, CDC.) Source: Rheumatologic,

Lead implantation for peripheral nerve stimulation (PNS)

Sensory distribution in the hand

When you perform the 1st CMC grind test, compress the joint and rotate thumb metacarpal. It’s the same motion you would use when using a mortar and pestle.

(A) A wrist extension immobilization splint is modified to hold a utensil for a client who does not have active grip. (B) A hand-based utensil holder is.

The “windshield wiper test” (passive internal and external hip rotation in 90 degrees of flexion). Pain and stiffness suggest hip joint arthritis. Source:

Clinical and pathologic effects of hepatocellular failure, which commonly results from conditions associated with acute or chronic necrosis of liver cells.

Copyright © 2004 The McGraw-Hill Companies, Inc. All rights reserved.

Copyright © 2004 The McGraw-Hill Companies, Inc. All rights reserved.

Presentation transcript:

Rheumatoid nodules, a common complication of rheumatoid arthritis, not only may result in pain and disfigurement but also may lead to compressive neuropathy secondary to pressure on superficial peripheral nerves. The nodules vary in size from a pea to a walnut and are commonly found in the metacarpophalangeal region of the hand, the wrist, and the elbow. Nodules may be functionally benign or may cause pain (especially over weight-bearing areas), become infected, or lead to tensile or compressive neuropathies if located along the path of a peripheral nerve. Source: Peripheral Neuropathy and Vasculitic, Connective Tissue, and Seronegative Spondyloarthropathic Disorders, Peripheral Nerve Injury Citation: Carp SJ. Peripheral Nerve Injury; 2015 Available at: http://fadavispt.mhmedical.com/DownloadImage.aspx?image=/data/books/1885/carppheripheral_fig-4-01.png&sec=139908968&BookID=1885&ChapterSecID=139908935&imagename= Accessed: October 24, 2017 Copyright © 2017 McGraw-Hill Education. All rights reserved