extra-articular clinical features of rheumatologic conditions
see also:
rheumatology
introduction
see also
arthritis - clinical patterns
for more details on patterns of disease in arthritis
the following is a quick aide memoire of the common conditions which cause
joint swelling
and some of their extra-articular manifestations which may provide clues to the diagnosis.
nails:
pitting:
psoriasis
skin/hair:
alopecia
, scalp lesions:
systemic lupus erythematosus (SLE)
,
psoriasis
pustular:
gonococcaemia; psoriasis;
malar rash:
SLE,
dermatomyositis
extensor surfaces rash:
psoriasis
dorsum hand rash:
dermatomyositis
tightening of skin:
scleroderma
erythema chronicum migrans:
Lyme disease
hyperkeratotic lesions:
Reiter's syndrome
generalised rash:
rubella
tophi:
gout
track marks:
IV drug abuse
erythema marginatum:
rheumatic fever
subcutaneous nodules:
rheumatoid arthritis
Raynaud's phenomenon:
95% of pts with
scleroderma
25% of pts with
Sjögren's syndrome (SS)
,
systemic lupus erythematosus (SLE)
or
dermatomyositis
5% of pts with
rheumatoid arthritis
NB.
Primary Raynaud disease
eyes:
dryness:
Sjogren's syndrome
iritis/uveitis:
seronegative spondyloparthropathies:
severe in Behcet's; pauciarticular ANA +ve JCA;
common in ankylosing spondylitis, Reiter's syndrome
rare in psoriatic arthropathy
HLA-B27 idiopathic
gonorrhoea
conjunctivitis:
Reiter's syndrome
icterus:
hepatitis
oral mucosa:
dryness:
Sjogren's syndrome
ulcerations:
SLE, Reiter's syndrome
pulmonary:
interstitial fibrosis:
scleroderma
pleuritis:
SLE, RhA
cardiac:
friction rubs:
RhA, SLE
murmurs:
SBE, RhA
GIT:
hepatomegaly:
hepatitis
inflammatory bowel disease
neurologic:
peripheral neuropathy/mononeuritis multiplex:
vasculitis
genitalia:
urethral discharge/lesions:
Reiter's; gonococcal;