Wegner's Granulomatosis

Clincal Features Vasculitis affecting small and medium sized Rhinitis (most common), Saddle nose, congestion Rapid progressing glomerulonephritis

Polyarteritis Nodosa

Small and Medium sized arteries(@ vessel Constitutional symptoms:fever, malaise, anorexia, Livedo reticularis increase BUN/creatinine Testicular pain Diastolic >90

Polymyalgia Rheumatica

Inflammatory large blood vessels NO VEIN INVOLVEMENT Pain&Stiffness in shoulders/hips b/l Constitutional symptoms

Temporal Arthritis(Giant Cell)

Medium and large arteries of head (external Bruits Headache Temporal scalp tenderness Blurred vision Polymyalgia rheumatica

Gonococcal Arthritis(infectious

Caused by N. Gonorrhea Local infection: affect knee Systemic: dermatitis, tenosynovitis, migratory

Non Gonococcal Arthritis

Similar to gonococcal arthritis

Diagnosis C-ANCA positive Leukocytoclastic vascullitis w/ necrosis Granulomatous inflammation Chest xray: coin lesions, infiltrates, cavities Urine: hematuria, RBC cast

Treatment Corticosteroids & Cyclophosphamide Rituximab & Glucocorticoids (prednisone) Plasmapheresis, plasma exchange

HBsAg or HBsAb positive Angiogram: aneurysm or occlusion Arterial Biopsy- polymorphonuclear

Corticosteroids Cyclophosphamide Hep B: Corticosteroids, antivirals, plamapheresis Surgery

Diagnosis of exclusion increase acute phase reactants (ESR, C

LOW DOSE PREDNISONE NSAIDS diet, exercise

Goldstandard: Biopsy: Giant cell infiltration Increased Alkaline phosphatase Tenderness, prominent temporal arteries,

HIGH DOSE PREDNISONE (lower dose 2-4 weeks,

Xray Arthrocentesis Blood culture

Ceftriaxone & azithromycin (co infection w/ Synovial fluid drainage Immobilization

Xray Arthrocentesis Blood culture

Treat underlying condition antiviral, antibiotic

Miscellaneous Arthritis Gingivitis, oral ulcers

Associated w/ viral infections(HBV, HIV, HCV) Microaneurysm formation>aneurysmal 1. Subacute: infiltration of mononuclear cells 2. Acute: infiltration of polymorphonuclear cells 3. Chronic: Fibrinoid necrosis> tissue infarction

Seen in 50% patients with temporal arthritis seen in patients > 50

Claudication of mastication muscles Tinnitus