Abstract
The lecture covers main approaches to differential diagnosis in rheumatic diseases. It highlights the key questions that should be answered at the primary examination of the patient. The most important signs that can identify severe, sometimes urgent nonrheumatic diseases are presented. The author describes pain of different patterns and intensity and the most common variants of acute or chronic onset of mono-, oligo-, or polyarthritis. The 2016 European League Against Rheumatism (EULAR) definition of arthralgia suspicious for the development of rheumatoid arthritis is given. The lecture presents the signs indicating the inflammatory nature of back pain in cases of suspected spondyloarthritis (SpA), as well as a two-step diagnostic strategy for axial SpA. Attention is paid to the semiotics of joint damage and extra-articular manifestations in various rheumatic diseases. A brief algorithm for a differential diagnostic search for joint pain is given.
Highlights
Дифференциальная диагностика при поражении суставов и позвоночникаВ лекции отражены основные подходы к дифференциальной диагностике при ревматических заболеваниях
The lecture covers main approaches to differential diagnosis in rheumatic diseases
It highlights the key questions that should be answered at the primary examination of the patient
Summary
В лекции отражены основные подходы к дифференциальной диагностике при ревматических заболеваниях. The lecture covers main approaches to differential diagnosis in rheumatic diseases. The lecture presents the signs indicating the inflammatory nature of back pain in cases of suspected spondyloarthritis (SpA), as well as a two-step diagnostic strategy for axial SpA. A brief algorithm for a differential diagnostic search for joint pain is given. При первом обращении пациента с болью в периферических суставах или в области позвоночника врач должен ответить на следующие ключевые вопросы:. – является ли болевой синдром симптомом ревматического заболевания или связан с другой патологией – есть ли подозрение на развитие хронического воспалительного заболевания суставов, например ревматоидного артрита (РА)?. Признаки («красные флаги»), позволяющие заподозрить, что имеющийся у больного симптомокомплекс не относится к проявлениям ревматического заболевания, представлены в табл. «Красные флаги» при боли в структурах опорно-двигательного аппарата Table 1. Red flags for pain in the structures of the locomotor system
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