DR. CORA LIM
MEDICAL INSIDER
Rheumatology Made Simple
(Part 4)
This is part 4 of our discussion of “Rheumatology Made Simple”.
Our first question is When to treat Hyperuricemia? These are the pointers for this question: The cause cannot be corrected e.g. obesity, hypertension, hypercholesterolemia; Two or three definite gout attacks; Tophaceous gout; Urinary calculi and/or urinary UA >800 mg/day; Tumor lysis (risk of acute uric acid nephropathy)
Another question is: What are the Differential Diagnoses For Monoarthritis? These are the pointers to this question: Fever before and during monoarthritis suggests septic arthritis; Persistent monoarthritis (and fever) despite NSAIDs or colchicine, suggests septic arthritis; In case of doubt, treat as septic arthritis; Gout and septic arthritis can co-exist.
What is the Treatment Of Septic Arthritis is another question to be considered, and these are the answers: Antibiotics, Drainage, and Joint immobilization (during acute phrase)
We talk now about Arthritis – Rash Syndromes. Some Arthritis Rash Syndromes are: Conjunctivitis in Reiter’s Syndrome; Maculopappules on the trunk in Reiter’s Syndrome; Keratoderma Blennorrhagica in Reiter’s Syndrome.
We also have the topic on Psoriatic Arthritis. This
characteristically presents as scaly rashes, onycholysis, and asymmetric oligo- or polyarthritis.