ESTER Reumatologia key terms

Inflammation of the synovial membrane lining a joint, producing pain, swelling, warmth and morning stiffness; the cardinal lesion of rheumatoid arthritis and other inflammatory arthritides.

Proliferating inflammatory tissue of synovial origin that erodes cartilage and subchondral bone; its presence on imaging or at surgery marks aggressive, destructive arthritis.

Stiffness felt on waking that improves with movement; lasting over an hour suggests inflammatory arthritis, whereas brief stiffness favours mechanical osteoarthritis.

A focal loss of cortical bone at the joint margin detectable on plain radiography; a hallmark of inflammatory arthritis and a component of radiographic damage scores.

Autoantibody directed against the Fc portion of immunoglobulin G, found in most people with rheumatoid arthritis but also in other diseases and in healthy older adults.

Antibodies against cyclic citrullinated peptides; highly specific for rheumatoid arthritis, often present years before symptoms, and associated with erosive disease.

A group of inflammatory diseases sharing sacroiliitis, axial involvement, enthesitis and association with HLA-B27, including ankylosing spondylitis, psoriatic arthritis and reactive arthritis.

Inflammation of the sacroiliac joints, causing inflammatory low back pain and buttock pain; detected by MRI early and by plain radiography later as sclerosis or fusion.

Inflammation at the insertion of tendon, ligament or joint capsule into bone, typically causing heel or elbow pain; a characteristic feature of spondyloarthritis and related conditions.

Diffuse swelling of an entire digit giving a sausage-like appearance, caused by inflammation of tendon sheaths and joints; typical of psoriatic arthritis and other spondyloarthritides.

A major histocompatibility complex class I allele strongly associated with ankylosing spondylitis and related spondyloarthritides; useful in supporting diagnosis but not diagnostic alone.

Crystal arthropathy caused by deposition of monosodium urate in joints and tissues, producing sudden severe monoarthritis, tophi and urate kidney stones.

A deposit of monosodium urate crystals in skin, soft tissue or bone, appearing as a firm nodule; indicates chronic gout and high cumulative urate burden.

Crystal arthropathy from calcium pyrophosphate crystals in cartilage and joints, causing acute pseudogout attacks and chronic degenerative arthritis, often with chondrocalcinosis on radiographs.

Degenerative joint disease with cartilage loss, subchondral sclerosis, osteophyte formation and synovial inflammation, causing activity-related pain and brief morning stiffness.

Bony enlargements at the distal interphalangeal joints caused by osteophytes in osteoarthritis; their proximal counterparts are Bouchard nodes.

Multisystem autoimmune disease with antinuclear antibodies, causing rash, arthritis, serositis, nephritis, cytopenias and neuropsychiatric features, with relapsing and remitting course.

Antibodies binding components of the cell nucleus, detected by immunofluorescence; sensitive screening markers for connective tissue disease but common in healthy people at low titre.

Antibodies against native double-stranded DNA, highly specific for systemic lupus erythematosus and associated with disease activity, particularly renal flares.

Immune-complex glomerulonephritis in systemic lupus erythematosus, causing proteinuria, haematuria and hypertension; classified by biopsy to guide immunosuppressive treatment.

Autoimmune disorder with antiphospholipid antibodies causing recurrent venous or arterial thrombosis and pregnancy loss; treated with anticoagulation rather than immunosuppression.

Episodic vasospasm of digital arteries triggered by cold or stress, causing colour change from white to blue to red; primary when isolated, secondary when linked to connective tissue disease.

Connective tissue disease with vasculopathy and fibrosis of skin and internal organs, causing skin thickening, Raynaud phenomenon, oesophageal dysmotility and interstitial lung disease.

Thickening and tightening of the skin of the fingers, producing tapering and reduced mobility; a defining feature of systemic sclerosis.

Autoimmune disease of exocrine glands causing dry eyes and dry mouth, often with anti-Ro or anti-La antibodies, fatigue, arthralgia and increased risk of lymphoma.

Antibodies targeting neutrophil granule proteins, tested by immunofluorescence and enzyme immunoassay; their pattern helps classify small-vessel vasculitis such as granulomatosis with polyangiitis.

Large-vessel vasculitis of older adults affecting cranial and aortic branches, causing headache, jaw claudication and visual loss; requires urgent glucocorticoids to prevent blindness.

Inflammatory syndrome of older adults with shoulder and hip girdle pain and stiffness, raised inflammatory markers and rapid response to low-dose glucocorticoids; often accompanies giant cell arteritis.

Small-vessel vasculitis with granulomatous inflammation of respiratory tract and necrotising glomerulonephritis, typically with anti-proteinase 3 antibodies; presents with sinusitis, haemoptysis and renal failure.

Skeletal disorder of reduced bone strength with low bone mineral density and microarchitectural deterioration, predisposing to fragility fractures, especially of hip, spine and wrist.

Imaging technique measuring bone mineral density at spine and hip, expressing results as T-score and Z-score; the standard method for diagnosing osteoporosis.

Bone mineral density expressed as standard deviations from the mean of a young healthy adult reference population; values of minus 2.5 or lower define osteoporosis.

A validated calculator estimating ten-year probability of hip and major osteoporotic fracture from clinical risk factors, with or without bone mineral density, to guide treatment decisions.

A fracture occurring after a fall from standing height or less, or without trauma, indicating compromised bone strength and increased risk of further fractures.

Defective mineralisation of bone in adults, usually from vitamin D deficiency, causing bone pain, proximal myopathy and pseudofractures; in children the equivalent disorder is rickets.

Disorder of focal accelerated bone turnover causing bone pain, deformity, enlarged skull and elevated alkaline phosphatase, with characteristic radiographic and scintigraphic appearances.

Chronic central pain syndrome with widespread musculoskeletal pain, fatigue, unrefreshing sleep and cognitive complaints, without inflammatory or structural joint disease.

Pain localised to one region such as shoulder, elbow or heel, arising from tendon, bursa, muscle or joint, usually mechanical rather than systemic in origin.

Compression of the median nerve within the wrist, causing nocturnal numbness and tingling in the thumb, index and middle fingers, thenar weakness and wasting.

Chronic arthritis beginning before age sixteen and lasting at least six weeks, classified by number of affected joints and systemic features, with risk of uveitis and growth disturbance.

Chronic asymptomatic intraocular inflammation complicating some forms of juvenile idiopathic arthritis, requiring regular slit-lamp screening because it can cause vision loss without symptoms.

Acute febrile vasculitis of young children with rash, conjunctivitis, mucosal changes, extremity swelling and cervical adenopathy, risking coronary artery aneurysms.

Benign recurrent leg pain in preschool and school-age children, typically bilateral, occurring late in the day and relieved by massage, with normal examination and no systemic features.