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diagnosis erythematosus sle systemic arthritis cardiology dermatology ecg ekg electrocardiogram equivalents msk myopathy myositis stemi symptoms vasculitis approach autoantibodies autoimmune
Skin Conditions Associated with Joint Pain Rash • Human parvovirus B19 infection Malar rash • SLE • Human parvovirus B19 infection •
• Rheumatic fever ... lesions • Discoid lupus ... #joint #pain #skin ... #rashes #differential ... #diagnosis #rheumatology
Clinical Features of Systemic Lupus (SLE) General: Fever (50%), Depression, Fatigue (75%), Weight loss (50%) Eye: Sjögrens (15%) Skin
Features of Systemic Lupus ... (SLE) General: Fever ... lesions Abdominal pain ... erythematosus #signs ... symptoms #diagnosis #rheumatology
Myositis and Myopathies Polymyositis • Progressive, symmetric muscle weakness • Elevated CK, +Anti-Jo, +Anti-Mi2 Dermatomyositis
Rheumatica • Pain ... , Fever, No muscle ... Diffuse muscle pain ... Myopathies #myopathy #differential ... diagnosis #comparison #rheumatology
Approach to Joint Pain - Diagnostic Framework 1) Chronicity 2) Inflammatory vs Non-Inflammatory 3) Number of Joints Involved 1) Chronicity:
acute rheumatic fever ... spondyloarthropathies, lupus ... #Joint #Pain #MSK ... #rheumatology # ... approach #workup #differential
STEMI Equivalents on ECG • Conventional STEMI - Elevation of ST segment at (or 40-60 ms
• De Winter syndrome ... V2 • Wellens sign ... accompanied by chest pain ... • Wellens sign ... EKG #diagnosis #differential
Systemic Lupus Erythematosus - Diagnosis Manifestations: - Arthritis 69% - Malar rash 40% - Fever 36% -
Malar rash 40% - Fever ... (aPL) 30-45% Differential ... autoantibodies #signs ... symptoms #mimickers #differential ... #rheumatology
Approach to Joint Pain - Arthritis Differential Diagnosis Framework Inflammatory Versus Noninflammatory Pain • Is it inflammatory
Differential Diagnosis ... noninflammatory Signs ... • Rheumatic fever ... #pain #Differential ... Diagnosis #MSK #rheumatology
Top 10 situations when to think about lupus 1) Inflammatory joint pain (especially in the wrists and
) Inflammatory joint ... pain (especially ... the face (many differential ... 9) Unexplained fever ... erythematosus #rheumatology
Approach to ECGs - Ischemia MI = Biomarkers + ECG or echo/angiogram findings Pathologic Q - 1/3 height
infarct STEMI - J point ... Equivalents / Don't Miss Signs ... bigger than QRS - deWinter ... -4 can have no pain ... Interpretation #differential
SLE (Systemic Lupus Erythematosus) Suspect: Clinical evidence of (fatigue, rash, photosensitivity, inflammatory arthritis, weight loss, and fever) and
weight loss, and fever ... permanent alopecia Differential ... Arthritis: • Joint ... pain • Swan neck ... Erythematosus #Diagnosis #Rheumatology
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