Page 18 – Rheumatology Advisor

Osteomyelitis

Preliminary Diagnosis: Osteomyelitis I. What imaging technique is first-line for this diagnosis? Plain film radiography II. Describe the advantages and disadvantages of this technique for diagnosis of osteomyelitis. Advantages Quick Can reliably exclude common causes of musculoskeletal pain, such as fracture, arthropathy, or neoplasm Can strongly suggest osteomyelitis given the appropriate clinical history, laboratory findings,…

Olecranon Bursitis

Preliminary Diagnosis: Olecranon Bursitis I. What imaging technique is first-line for this diagnosis? MRI with contrast II. Describe the advantages and disadvantages of this technique for diagnosis of olecranon bursitis. Advantages Able to detect other causes of pain or weakness in the joint such as triceps tendinopathy, tenosynovitis, tears or ulnar nerve damage Does not…

Multiple Sclerosis

Preliminary Diagnosis: Multiple Sclerosis I. What imaging technique is first-line for this diagnosis? Contrasted MR of the brain per demyelinating protocol Contrasted MR of the cervical spine may additionally be performed to search for any cervical spine demyelinating plaques. II. Describe the advantages and disadvantages of this technique for diagnosis of multiple sclerosis. Advantages Highly…

Peptic Ulcer Disease

Preliminary Diagnosis: Peptic Ulcer Disease I. What imaging technique is first-line for this diagnosis? Fluoroscopic upper GI series II. Describe the advantages and disadvantages of this technique for diagnosis of peptic ulcer disease. Advantages Diagnostic in advanced cases of peptic ulcer disease when ulcers are usually greater than 1cm Imaging features can aid in determining…

Abdominal Aortic Aneurysm

Preliminary Diagnosis: Abdominal Aortic Aneurysm I. What imaging technique is first-line for this diagnosis? CT with contrast/CT angiogram II. Describe the advantages and disadvantages of this technique for diagnosis of abdominal aortic aneurysm. Advantages Distinguishes residual lumen from mural thrombus, leaking or ruptured aneurysm Delineates branch vessel anatomy Good for evaluation after endovascular repair Disadvantages…

Nephrolithiasis

Preliminary Diagnosis: Nephrolithiasis I. What imaging technique is first-line for this diagnosis? Computed tomography (CT) scan without oral and without intravenous contrast II. Describe the advantages and disadvantages of this technique for diagnosis of nephrolithiasis. Advantages Able to locate an obstructive radiopaque renal, collecting system, and urinary bladder calculi Relatively quick imaging modalities that require…

Meningitis

Preliminary Diagnosis: Meningitis I. What imaging technique is first-line for this diagnosis MR imaging of the brain and spine with and without contrast II. Describe the advantages and disadvantages of this technique for diagnosis of meningitis. Advantages May be diagnostic in certain clinical settings Able to locate the focal area of meningeal inflammation and predict…

Encephalitis

Preliminary Diagnosis: Encephalitis I. What imaging technique is first-line for this diagnosis? MR imaging with intravenous contrast of the brain. II. Describe the advantages and disadvantages of this technique for diagnosing encephalitis. Advantages Diagnostic with positive pertinent findings in the correct clinical setting, including focal parenchymal inflammation secondary to a viral infection. Able to locate…

Restless legs syndrome

Restless Legs Syndrome I. What every physician needs to know. Restless legs syndrome (RLS), also known as Willis-Ekbom disease, is a sensory disorder of the nervous system that affects both children and adults. Women are more commonly affected than men, as are those of northern European descent. Unless the symptoms are overwhelming, RLS is often…

Nephrolithiasis

Nephrolithiasis I. What every physician needs to know Stones composed of calcium phosphate or calcium oxalate make up 85-90% of renal stones in the United States. Precipitation of calcium in urine causes these stones, and stones have been linked to hypercalciuria, high salt diets, obesity, hypertension, diabetes, genetic factors, and environmental factors. Uric acid, cystine,…

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