Rheumatology Review

How to Approach Arthritis DURATION ACUTECHRONIC INFLAMMATION? YESNO Crystal Deposition Infection Early Chronic Trauma Hemarthrosis OA JOINT INVOLVEMENT MONOOLIGOPOLY (symmetry) Early Oligo/Poly Chronic/Indolent Infection Seronegative disease Sjögren’s RA SLE Seronegative Chronic Tophaceous Gout

 Any 4 of the following 11 criteria (simultaneously or sequential) needed to help diagnose SLE Serositis (pleuritis, pericarditis) Serositis (pleuritis, pericarditis) Oral Ulcers Oral Ulcers Non-deforming Arthritis Non-deforming Arthritis Photosensitivity Photosensitivity Blood disorders (such as hemolytic anemia or pancytopenia in absence of offending drug/agent) Blood disorders (such as hemolytic anemia or pancytopenia in absence of offending drug/agent) ANA positive ANA positive Renal Disease Renal Disease Malar Rash (distinct from photosensitivity) Malar Rash (distinct from photosensitivity) Discoid Rash Discoid Rash Neurologic Disorders (seizures, psychosis, etc) Neurologic Disorders (seizures, psychosis, etc) Presence of Anti-Smith, anti-phospholipids, anti- dsdna, false positive syphilis test Presence of Anti-Smith, anti-phospholipids, anti- dsdna, false positive syphilis test Diagnostic Criteria for SLE

 Any 4 of the following 7 criteria. Primarily used for research purposes, made prior to discovery of anti-ccp Morning stiffness > 1hour for at least 6 weeks Morning stiffness > 1hour for at least 6 weeks Arthritis and soft tissue swelling of at least 3 joints for > 6 weeks Arthritis and soft tissue swelling of at least 3 joints for > 6 weeks Arthritis of hand joints > 6 weeks Arthritis of hand joints > 6 weeks Symmetric arthritis for > 6 weeks Symmetric arthritis for > 6 weeks Rheumatoid factor above the 95 th percentile Rheumatoid factor above the 95 th percentile Erosive arthropathy on films Erosive arthropathy on films Subcutaneous nodules Subcutaneous nodules Diagnostic Criteria for RA

Sjögren’s, Lupus, neonatal heart block Lupus CREST Scleroderma RA Antiphospholipid Syndrome Antiphospholipid Syndrome Name That Antibody Anti-Ro (SS-A), Anti-La (SS-B) Anti-Smith, Anti-Double Stranded Anti-Centromere Anti-Scl70 (anti-topoisomerase) Anti-CCP, RF Lupus Anticoagulant

Mixed Connective Tissue Disease Stiff Man Syndrome Stiff Man Syndrome CREST Scleroderma Dermato/Polymyositis Celiac Disease Celiac Disease Name That Antibody Anti-RNP Anti-GAD Anti-Centromere Anti-Scl70 (anti- topoisomerase) Anti-Mi-2, Anti-Jo1 Anti-Transglutaminase

Autoimmune Hepatitis Primary Biliary Cirrhosis Churg-Strauss, Microscopic Polyangitis Wegener’s Drug Induced Lupus Seronegative Arthritis Name That Antibody Anti-Smooth Muscle Anti-Mitochondrial Antibody p-ANCA c-ANCA Anti-Histone Abs HLA-B27

Gratuitous photos

Sjögren’s, Lupus, neonatal heart block Anti-Ro (SS-A), Anti- La (SS-B) Lupus Anti-Smith, Anti- Double Stranded Abs CRESTAnti-Centromere Scleroderma Anti-Scl70 (anti- topoisomerase) RA Anti-CCP, RF Antiphospholipid Syndrome Antiphospholipid Syndrome Lupus Anticoagulant Name That Antibody

Mixed Connective Tissue Disease Anti-RNP Stiff Man Syndrome Stiff Man Syndrome Anti-GAD CRESTAnti-Centromere Scleroderma Anti-Scl70 (anti- topoisomerase) Dermato/Polymyositis Anti-Mi-2, Anti-Jo1 Celiac Disease Celiac Disease Anti- Transglutaminase Name That Antibody

Autoimmune Hepatitis Anti-Smooth Muscle Ab Primary Biliary Cirrhosis Anti-Mitochondrial Antibody Churg-Strauss, Microscopic Polyangitis p-ANCA Wegener’s c-ANCA Drug Induced Lupus Anti-Histone Abs Seronegative Arthritis No Ab. HLA-B27 Name That Antibody