PHAR 454 Lecture Notes - Lecture 8: Erythrocyte Sedimentation Rate, Pelvic Girdle Pain, C-Reactive Protein
5 Apr 2017
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Document Summary
Common condition that is seen in the primary care setting. Genetic: may be an association between pmr and specific polymorphisms in genes related to immune regulation, controversy: eg. hla-drb1 genotypes have been linked to susceptibility and severity. Immunogenic: peak incidence coincides with epidemics of. Environmental: occurs more frequently in the winter months. Clinical features: higher prevalence in rural manitoba compare to urban, uk, higher prevalence in north vs. south. Physical examination is usually less striking than history. Listen to the story which tends to be the same with most patients. Aching and stiffness in the morning that lasts for 30 minutes or more, worsening stiffness after rest. Affecting shoulder girdle (70-95%), hip girdle and neck muscles (50-70%) Pain is more severe with movement, can interfere with sleep. Fatigue, malaise, anorexia, weight loss, low grade fever, depression. Pitting edema over dorsum of hands and wrists, over ankles and tops of feet (represents tenosynovitis and synovitis)
