00:00 / 00:00
Lordosis, kyphosis, and scoliosis
Osteomalacia and rickets
Paget disease of bone
Calcium pyrophosphate deposition disease (pseudogout)
Juvenile idiopathic arthritis
Inclusion body myopathy
Degenerative disc disease
Spinal disc herniation
Achilles tendon rupture
Anterior cruciate ligament injury
Iliotibial band syndrome
Patellar tendon rupture
Patellofemoral pain syndrome
Carpal tunnel syndrome
Thoracic outlet syndrome
Radial head subluxation (Nursemaid elbow)
Rotator cuff tear
Lambert-Eaton myasthenic syndrome
Limited systemic sclerosis (CREST syndrome)
Mixed connective tissue disease
Systemic lupus erythematosus
Developmental dysplasia of the hip
Osgood-Schlatter disease (traction apophysitis)
Slipped capital femoral epiphysis
Back pain: Pathology review
Bone disorders: Pathology review
Bone tumors: Pathology review
Gout and pseudogout: Pathology review
Muscular dystrophies and mitochondrial myopathies: Pathology review
Myalgias and myositis: Pathology review
Neuromuscular junction disorders: Pathology review
Pediatric musculoskeletal disorders: Pathology review
Rheumatoid arthritis and osteoarthritis: Pathology review
Scleroderma: Pathology review
Seronegative and septic arthritis: Pathology review
Sjogren syndrome: Pathology review
Systemic lupus erythematosus (SLE): Pathology review
While doing your rounds, you see Rosa, a 35-year-old woman who has complained of puffy hands and feet for the past 4 months.
On examination, the skin on the limbs and trunk is stiff and shiny, with decreased markings.
Other important findings are sclerodactyly, Raynaud's phenomenon, and digital ulceration.
Pulmonary function tests were performed as well, and they showed a pattern suggestive of restrictive lung disease.
Then you see Haruki, a 65-year old who says that he noticed skin changes recently, stating that the wrinkles on his face have disappeared.
He also said that his acid reflux got worse in the past 6 months.
On examination, his hands show Raynaud's phenomenon and sclerodactyly.
The skin on his face and the arms below the elbow were tight, shiny, smooth, with no wrinkles.
Pulmonary function tests are normal.
Blood tests were performed in both cases, showing increased serum levels of anti-Scl 70 and and-RNA polymerase III antibodies in Rosa, and increased anti-centromere antibodies in Haruki.
Now, both seem to have scleroderma.
Scleroderma refers to systemic sclerosis, a rare autoimmune disorder in which normal tissue is replaced by thick, dense collagen.
It affects the skin, blood vessels and internal organs.
Now, there are two main types of scleroderma, diffuse cutaneous systemic scleroderma; and limited cutaneous systemic scleroderma, which was formerly called CREST syndrome.
The condition’s pathology is not completely understood, but it’s believed that some individuals have a genetic predisposition to scleroderma which is triggered by external factors.
These triggers include: viral infection by cyto-megalo-virus and parvovirus B19; exposure to silica dust, organic solvents, vinyl chloride; and medication like cocaine, bleomycin, and pentazocine.
Scleroderma, also known as systemic sclerosis, is a chronic systemic autoimmune disease characterized by progressive fibrosis of skin and internal organs such as the gastrointestinal tract, lungs, heart, and kidneys. The exact cause is unknown but is associated with autoimmune processes that lead to excessive collagen production in individuals with a genetic predisposition. Scleroderma can be either limited or diffuse, with symptoms varying according to the organs involved. Treatment options involve immunosuppressants and medications to relieve symptoms and slow the progression of the disease.
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