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Systemic Lupus Erythematosus (SLE): Musculoskeletal Manifestations

 • Immune Complex Deposition
    - Arthralgia, Arthritis
Systemic Lupus Erythematosus ... - Arthralgia, Arthritis ... Normal CK - Myositis ... #SLE #MSK #Musculoskeletal ... pathophysiology #signs
Clinical Features of Systemic Lupus (SLE)
General: Fever (50%), Depression, Fatigue (75%), Weight loss (50%)
Eye: Sjögrens (15%)
Skin
of hip (rare), Arthritis ... lesions Abdominal pain ... Glomerulonephritis Myositis ... #signs #symptoms ... #diagnosis #rheumatology
Systemic Lupus Erythematosus - Diagnosis
Manifestations:
 - Arthritis 69%
 - Malar rash 40%
 - Fever 36%
 -
Systemic Lupus Erythematosus ... Manifestations: - Arthritis ... anemia 4% - Myositis ... autoantibodies #signs ... #differential #rheumatology
Antinuclear Antibodies (ANA)
ANA or Anti-NucIear Antibody refers to antibodies against antigens in the nucleus → like
assay (IFA) is the main ... erythematosus ( ... erythematosus ( ... Sjögren Syndrome, Myositis ... #patterns #rheumatology
SLE (Systemic Lupus Erythematosus)

Suspect:
Clinical evidence of (fatigue, rash, photosensitivity, inflammatory arthritis, weight loss, and fever) and
findings (ANA, ... Non-autoimmune rheumatologic ... : • Joint pain ... • Transverse Myelitis ... #Diagnosis #Rheumatology
Approach to Joint Pain - Arthritis Differential Diagnosis Framework

Inflammatory Versus Noninflammatory Pain
 • Is it inflammatory
noninflammatory Signs ... - Autoimmune Rheumatologic ... • Hepatitis B virus ... #Diagnosis #MSK ... #rheumatology #
Vasculitis and Vasculitides - Differential Diagnosis Framework

When to Consider Vasculitis:
 • Purpura, ischemic skin lesions
 •
rapidly progressing GN ... erythematosus, ... purpura: strong sign ... LFT • ESR • ANA ... differential #diagnosis #rheumatology
Macrophage Activation Syndrome (MAS)
Classified among the secondary or acquired forms of haemophagocytic lymphohistiocytosis (sHLH)

What?
A subset of
erythematosus ... • Fever is the main ... erythematosus [ ... Diagnosis #Management #Hematology ... #Rheumatology
Vasculitis - Differential Diagnosis Framework

When to Consider Vasculitis:
• Purpura, ischemic skin lesions
• Mononeuritis multiplex
• Hematuria, proteinuria,
purpura: Strong sign ... ischemia • Skin: Erythematous ... tract: Abdominal pain ... and GN Anti-GBM ... Differential #Diagnosis #Rheumatology
Rheumatology Workup - Laboratories Studies in Rheumatic Diseases

• Septic arthritis - Gram stain and culture of
Rheumatology Workup ... joint • Systemic lupus ... erythematosus ( ... level to exclude myositis ... low back pain)