MUSCULOSKELETAL MANIFESTATION

MUSCULOSKELETAL MANIFESTATION IN

SYSTEMIC DISEASES & DRUGS
Endocrine disease:
A- Hypothyroidism:
1. CTS
2. Sever painful, symmetric, proximal myopathy & muscle hypertrophy
B- Hyperparathyroidism:
1.Chondrocalcenosis:.
2.Pseudogout attacks (CPD crystals) & calcific periarthritis.

C- Diabetes Mellitus:

1. Diabetic cheiroarthropathy:
Tightening of the skin & periarticular contracture (prayer sign).
2. Diabetic osteopathy:
Forefoot pain metatarsalgia
3. Frozen shoulder:
4. Dupuytren s contracture

5. Septic arthritis:

6.Neuropathic joint (Charcot arthropathy):
-Repetitive micro trauma following sensory loss & altered
Blood flow 2ndry to impaired sympathetic system control.
-Clinical features:
1- Painful swelling of one of( knee, ankle or elbow)
2- Marked instability & deformity (Flail joint).

- X-ray:

*Gross loss of cartilage & with disorganization of normal architecture.
*Multiple loose bodies.
*Hypertrophic new bone formation.
-Treatment:
*Orthosis
*Arthrodesis
- DDx:
*Syringomyelia
*Leprosy
*Tabes dorsalis
D- Acromegaly:
1. Lower backache
2. CTS
3. Raynaud s phenomena


Malignancy:
- Poly articular arthritis seen in CA & leukemia.
- HPOA
- Myeloprlifarative disease associated with gout.
- Myeloma
- Lymphoma-associated with PM & DMS
- Cryoglubulinemia.

Drugs induce MSK manifestations:

Diuretics --------------------------- 2ndry gout
Corticosteroid--------------------- Osteoporosis Osteonecrosis Myopathy
Anticonvulsant-------------------- Osteomalacia
Pencillamine----------------------- Myositis Myasthenia
Chloroquine-------------------------- Myopathy
Procainamine-----------------------Drug induce SLE
Hydralazine-------------------------- Drug induce SLE
INH----------------------------------- Drug induce SLE
Chlorpromazine------------------- Drug induce SLE

Ideal Group

A.H.Yahia