NR 509 NEW UPDATED VERIFIED A+ GRADE

Articular structures include joint capsule and articular cartilage, the synovium and
synovial fluid, intra-articular ligaments and juxta-articular bone
o Articular disease involves:
▪ Swelling
▪ Tenderness of the joint
▪ Crepitus
▪ Instability “locking”
▪ Deformity
▪ Limits active and passive range of motion due to stiffness or pain
 Extra-articular structures include periarticular ligaments, tendons, bursae, muscle,
fascia, bone, nerve and overlying skin
o Extra-articular disease involves:
▪ “point of focal tenderness in regions adjacent to articular structures
▪ Limits active range of motion
▪ RARELY causes swelling, instability, joint deformity
Know the sources of joint pain (pg. 627 algorithm)
 Nonarticular conditions: trauma/fracture, fibromyalgia, polymyalgia rheumatica,
bursitis, tendinitis
 Intra-articular (acute, < 6 weeks): acute arthritis
o infectious arthritis
o gout
o pseudogout
o Reiter syndrome
 Intra-articular (chronic, > 6 weeks): chronic inflammatory arthritis vs chronic
noninflammatory arthritis
o Chronic inflammatory arthritis with 1-3 joints involved:
▪ Indolent infection
▪ Psoriatic arthritis
▪ Reiter syndrome
▪ Periarticular JA
o Chronic inflammatory arthritis with >3 joints involved:
▪ Psoriatic arthritis or Reiter syndrome (no symmetry)
▪ rheumatoid arthritis if not RA then  systemic lupus, scleroderma,
polymyositis
*Know what causes saddle numbness and urinary retention (pg. 678?)
 CES (cauda equina syndrome) most commonly results from a massive herniated disc in the
lumbar region.
 A single excessive strain or injury may cause a herniated disc Articular structures include joint capsule and articular cartilage, the synovium and
synovial fluid, intra-articular ligaments and juxta-articular bone
o Articular disease involves:
▪ Swelling
▪ Tenderness of the joint
▪ Crepitus
▪ Instability “locking”
▪ Deformity
▪ Limits active and passive range of motion due to stiffness or pain
 Extra-articular structures include periarticular ligaments, tendons, bursae, muscle,
fascia, bone, nerve and overlying skin
o Extra-articular disease involves:
▪ “point of focal tenderness in regions adjacent to articular structures
▪ Limits active range of motion
▪ RARELY causes swelling, instability, joint deformity
Know the sources of joint pain (pg. 627 algorithm)
 Nonarticular conditions: trauma/fracture, fibromyalgia, polymyalgia rheumatica,
bursitis, tendinitis
 Intra-articular (acute, < 6 weeks): acute arthritis
o infectious arthritis
o gout
o pseudogout
o Reiter syndrome
 Intra-articular (chronic, > 6 weeks): chronic inflammatory arthritis vs chronic
noninflammatory arthritis
o Chronic inflammatory arthritis with 1-3 joints involved:
▪ Indolent infection
▪ Psoriatic arthritis
▪ Reiter syndrome
▪ Periarticular JA
o Chronic inflammatory arthritis with >3 joints involved:
▪ Psoriatic arthritis or Reiter syndrome (no symmetry)
▪ rheumatoid arthritis if not RA then  systemic lupus, scleroderma,
polymyositis
*Know what causes saddle numbness and urinary retention (pg. 678?)
 CES (cauda equina syndrome) most commonly results from a massive herniated disc in the
lumbar region.
 A single excessive strain or injury may cause a herniated disc