Primer on the Rheumatic Diseases (Primer on Rheumatic Diseases (Klippel))
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This is one of the most prestigious and comprehensive texts on arthritis and related diseases, including osteoarthritis, rheumatoid arthritis, osteoporosis, lupus and more than one hundred others. It offers medical students and physicians a concise description of the current science, diagnosis, clinical consequences, and principles of management. New and expanded chapters heighten the translational nature of this edition. Students, trainees, and practicing clinicians all need a standard textbook that can change with the times and reflect recent strides taken in understanding and treating rheumatic disease. The Primer fills that need.
In view of the recent remarkable strides in understanding and treating rheumatic disease, students, trainees, and practicing clinicians all need a standard textbook that can change with the times and reflect these advances. The Primer continues to fill that need. Read, learn, and enjoy. John H. Klippel, MD John H. Stone, MD, MPH Leslie J. Crofford, MD Patience H. White, MD, MA CONTENTS Foreword by Michael E. Weinblatt . . . . . . . . . . . . . . . . . . . . . . . . . . . v Preface . . . . .
J Clin Pathol 2002;55:4–13. CHAPTER 2 Evaluation of the Patient C. Arthrocentesis, Synovial Fluid Analysis, and Synovial Biopsy KENNETH H. FYE, MD When the diagnosis of an inflammatory arthropathy is unclear, synovial fluid should be evaluated for the three Cs: cell count, culture, and crystals. Removal of infected synovial fluid is often a critical adjunct to antibiotics in the treatment of a septic joint. Careful preparation, appropriate assistance, and planning of the approach to the
does not distinguish between infection, inflammation, and other conditions (2). Multidetector spiral CT is now used increasingly as a means of excluding pulmonary emboli, a complication to which many patients with rheumatic disorders (systemic lupus erythematosus, primary antiphospholipid antibody syndrome, Wegener’s granulomatosis) are susceptible. For pulmonary thromboembolism detection, the chest is scanned rapidly following a bolus intravenous injection of contrast medium, timed so that the
tendinitis, which usually produces more inflammation with pain and swelling. The calcification may be detected by plain x-ray. Magnetic resonance imaging (MRI) and ultrasonography are helpful in confirming a diagnosis of tendinitis. Even though the term tendinitis is used throughout this chapter, the term tendinosis might be more appropriate, as these conditions exhibit degenerative changes and few inflammatory cells (2). Tendino- CAUSATIVE FACTORS Many syndromes of the neuromusculoskeletal
effective in most instances, but more radical procedures, including digital amputation, may rarely be necessary. Palmar fasciotomy is a useful and more benign proce- dure, but if the disease remains active, recurrence is likely. DISORDERS OF THE HIP REGION Trochanteric Bursitis Although common, trochanteric bursitis frequently goes undiagnosed. It occurs predominantly in middleaged to elderly people, and somewhat more often in women than men. The main symptom is aching over the trochanteric