family history G gait patterns oligoarticular pains, 156, 165 low back pain, 74 \200\22375 spinal disorders, 87, 88 walking in bare feet, 125 gamma linol eic acid (GLA), widespread pain, 175 Fanconi syndrome, 457 febuxostat, gout, 275 Felty \200\231s syndrome, granulomatosis with polyangiitis, gut and hepatobiliary manifestations, 228t granulomatous vasculitis, childhood, 207t groin. See pelvic, groin, and 555 rheumatoid arthritis (RA), 242 feno \201 brate, gout, 276 \201 bromyalgia, 71t, 179, 180 f classi \201 cation criteria, gastrointestinal features Beh et \200\231s disease, 502 Sj gren \200\231s syndrome, 365 \200\223366 systemic lupus thigh pain gut and hepatobiliary 524, 525t erythematosus (SLE), 337t treatment, 525 \200\223526 \201 brosis, systemic sclerosis, manifestations rheumatic diseases, systemic sclerosis, 384, 378 385t 224 \200\223229, 227t, 228t rheumatological features, \201 brous dysplasia, 473 Finkelstein \200\231s test, wrist, 44 Five Factor Score (FFS), 419 \202 at feet, 132, 133t, 135t, 137 \202 exion/extension range tests, wrist, 44 genetic abnormalities, childhood, 188t genitals, systemic sclerosis 225t, 226t side effects from drugs, 229 and, 389t gut associated reactive giant cell arteritis (GCA) arthritis (GARA), 300 diagnosis of, 424, 426 \200\223427 emergency, 574 treatment of, 427 \200\223428 glandular d isease, Sj gren \200\231s syndrome, 364 glenohumeral joint gynecologic disease, 71t \202 exor carpi ulnaris (FCU), 59 \202 exor digitorum profundus (FDP), 59 H hallux valgus, foot, 124 hand. See also wrist pain \202 exor tendonopathy, 53 foot deformities, 124, 133t foot disorders in children corticosteroid injection, corticosteroid injection, and adolescents, 135t. See also lower leg and foot disorders (adults) 143 144 injection in, plate 12 movement of, 28 glucocorticoid-induced diagnoses from simple radiographs, 54t diagnostic tests, 53 \200\22355 digit deformities, 5 2 examination, 51 \200\22353 extensor expansion of background, 132 bone scan, 139, 140 common patterns of foot osteoporosis (GIO), 448, 448t glucocorticoids deformity, 133t corticosteroid injection, gut and hepatobiliary side \201 nger, 46 145 effects, 229 pregnancy, 256 functional anatomy, 46, 48f grip, 49 diagnostic procedures, 139 \200\223140 INDEX 583 corticosteroid injection, imaging, 54 \200\22355 intrinsic muscles, 46 ischemic pain, 50 \200\22351 laboratory tests, 55 long tendons, 46 muscles of hypothenar idiopathic osteoporosis, 144 \200\223145 446 \200\223447 examination, 98 \200\22399 functional anatomy, 93 testing passive hip idiopathic pulmonary \201 brosis, 376t idiopathic scoliosis, 546 IgM rheumatoid factor (R F), \202 exion and rotational movements and hip abduction, plate 9 eminence, 49t muscles of thenar eminence, 47t muscle wasting, 52 nail and \201 nger inspe ction, 244, 259 immunoglobulin, systemic lupus erythematosus (SLE), 346 immunologic features, homeopathy, 557 hormone replacement, osteoporosis treatment, 451 systemic lupus erythematosus (SLE), 337t 52 humerus, lateral epicondyle pain from bone, 50 radiographs, 53 \200\22354 stiffness, 49 \200\22350 swelling, 51, 52 tak ing a history, 49 \200\22351 tingling/pins and needles/ of, 37 immunosuppressive agents polymyositis (PM) and hydrocortisone acetate, injection therapy, 142 dermatomyositis (DM), 410 \200\223411 hydrotherapy, low back pain, 539t hydroxychloroquine systemic sclerosis, 390, numbness, 50 treatment, 55 \200\22356 trigger \201 nger, 51 weakness, 51 hands and nails, skin 391t gut and hepatobiliary side inclusion-body myositis effects, 229 pregnancy, 256 rheumatoid arthritis (RA), (IBM), 413 infection and rheumatic disease. See also rheumatic disease Lyme disease, 494, 495t management of pyogenic joint in fection, 486 \200\223487 249 \200\223250 systemic lupus disorders, 197 hands-on therapy, 556 Harpagophytum procumbens, erythematosus (SLE), 345, 347t hypercalcemia devil \200\231s claw, 555 hemarthrosis, oligoarticular management of septic causes of, 459t infancy and childhood, joint pain, 153t hematologic manifestations SLE (systemic lupus bursitis, 488 mycobacterium 459, 460t tuberculosis, 490 \200\223491 osteomyelitis, 492, 493t pathogenesis, 482, 483t pathogens as sociated with arthritis, 482, 484t parathyroid disease, 458 treatment, 459t erythematosus), 571 SLE \200\223 pediatric, 571, 573f hematopoietic involvement, hypergammaglobulinemic purpura, 440 Hypericum perforatum, systemic lupus erythematosus (SLE), 336 \200\223337 hemochromatosis, St. John \200\231s wort, 555 hypermobility, 71t, 476, 478 hyperparathyroidism, pyogenic nongonococcal and gonococcal arthritides, 486 \200\223488 rheumatic fever, 496 \200\223498 rheumatic features, 226t 222 \200\223223 hyperthyroidism, 449 hypertrophic pulmonary Henoch \200\223Sch nlein purpura, infections 228t, 439 oligoarticular pains with, hepatitis A, rheumatic features, 225t osteoarthropathy (HPOA), 232 hyperuricemia, gout and, 155 \200\223156, 164 patients taking anti- hepatitis B TNF-A drugs, 566, 567t infection with acute polyarthritis, 175t rheumatic features, 225t 272 \200\223276 hypnotherapy, 558 hypogonadism, 449 hypothyroidism, 221 \200\223222 rheumatoid arthritis (RA), 242 vasculitis, 203t hepatitis C, rheumatic features, 225t hepatobiliary disease, infectious myositis, cause of myopathies, 176t in \202 ammatory diseases childhood, 188t o ligoarticular pains, I idiopathic in \202 ammatory Sj gren \200\231s syndrome, 365 \200\223366 hepatobiliary myopathies. See also dermatomyositis (DM); polymyositis (PM) 157, 166 manifestations. See gut and hepatobiliary manifestations systemic sclerosis, 378 vasculitis, 203t in \202 iximab, ankylosing autoantibodies in myositis, 406, 407t differential diagnosis of myopathy, 406, 408t herbal remedies, 555 herniated disc, 549 hindfoot disorders spondylitis (AS), 295 injections. See steroid injections injuries, knee, 107 interleukin-6 receptor antagonists, rheumatoid arthritis (RA), 255 epidemiology and examination, 125 \200\223126, diagnosis of, 398, 399t inclusion-body myositis 136 \200\223137 possible causes of pain, (IBM), 413 122, 123t treatment, 129 necrotizing myopathy, 413 hip joint INDEX 584 cutaneous, and articular syndrome (CINCA), 327 aspiration of joint and periarticular \202 uid collections, 115 biomechanical factors, International League of Associations for Rheumatology (ILAR), 162, 259 classi \201 cation, 164t, 186 differential diagnosis 116 juvenile idiopathic of, 187t causes of anterior, 108t chronic knee arthritis (JIA), 164t, 186 juvenile psoriatic arthritis enthesitis related arthritis, 326 in \202 ammation in juvenile idiopathic arthritis, plate 18 diagnostic procedures, (JPsA), 307 oligoarthritis, 312 interstitial lung disease, fever spikes, 188, 189f general management principles, 310 \200\223311 gut and hepatobiliar y manifestations, 227t increased growth due to chronic knee inflammation, plate 18 rheumatic disease, 214 114 \200\223116 drugs, 117 examination, 110 \200\223114 joint injection therapies, intestinal by-pass surgery, rheumatic features, 225t in-toeing, 132, 133t intra- and extramedullary tumors, radiographic features, 90t 117 joint synovitis, 111 \200\223112 knee locking, 108 \200\223109 laboratory tests, 115 \200 \223116 Lachman test, 112, 113f lateral view of thigh, 107f McMurray \200\231s test, 112, juvenile psoriatic arthritis, intratendinous, 123 intravenous gammaglobulin (IVIg), polymyositis (PM) and dermatomyositis (DM), 411 intrinsic renal failure 325 oligoarthritis, 312 \200\223315 rheumatoid factor negative polyarticular JIA, 322 \200\223323 rheumatoid factor 113f magnetic resonance positive polyarticular JIA, 324 (MR), 115 active sediment, 217 bland sediment, 217 \200\223218 onset and pattern, 109 past medical, family, occupational and leisure history, 109 Still \200\231s disease, 328 systemic, 162 systemic arthritis, ischemia, 174 ischemic pain, hands, 50 \200\22351 Iselin \200\231s disease, foot disorder, 135t 316 \200\223320 patella, 106, 107f posterior draw test, 112 radiographs, 114, 115t sitting patient, 110, 11 1f standing patient, 110 steroid injection, 116 surgery, 117 taking a history, 106 \200\223 109 test for knee stability, tests for investigating, 193t J Janus Kinase (JAK) juvenile idiopathic osteoporosis (JIO), 447, 447t inhibitors, rheumatoid arthritis (RA), 255 \200\223256 juvenile psoriatic arthritis, joint aspiration knee, 115 lower leg and foot, 129 oligoarticular pains, 158, 306, 307, 325 juvenile psoriatic arthritis (JPsA), 306, 307 112, 113f test for meniscus damage, 166 \200\223167 112, 113f, 114 treatment, 116 \200\223117 ultrasound, 115 K hler \200\231s disease, 135t, K Kawasaki disease joint diseases, nodules associated with, plate 16 joint \202 uid, characteristics, childhood vasculitis, 207t gut and hepatobiliary manifestations, 228t 159t 471t, 472 kyphosis, 71t, 87, 88 joint hypermobility syndrome (JHS), 524 vasculitis, 442 Kennedy \200\223Hawkins joint injection therapy. L Lachman test, knee stability, See also steroid injections knee pain, 117 test, subacromial impingement, 30f kidneys. See renal manifestations Klippel \200\223Feil, 88, 89 knee joint 112, 113f joint pain, 6 Langerhans cell histiocytosis radiographic features, 90t oligoarthritis, 312 \200\223313 patients with widespread large granular lymphocyte (LGL) syndrome, rheumatoid arthritis (RA), 242 pain, 178 sarcoidosis, 504 Sj gren \200\231s syndrome, 364 synovitis and knee pain, corticosteroid injection, 145 knee locking, 108 \200\223109 patellar tap test, plate 11 large joint osteoarthritis, 111 \200\223112 knee pain 265 juvenile dermatomyositis, gut and hepatobiliary manifestations, 228t anatomy of knee, 104, large-vessel vasculitis, 421 Lasegue \200\231s test, low back 105f, 106 anterior draw test, 112, pain, 76 juvenile idiopathic arthritis 113f lateral epicondylitis, 534, 535f diagnostic procedures, 534 management principles, (JIA) anterior knee structures, chronic, infantile, neurological, 105f ask about knee injury, 107 534 INDEX 585 radiographic Lyme disease, 156, 165 clinical features, 495t infection, 494 infection with acute polyarth ritis, 175t laboratory tests, 494 monoarticular/ pragmatic algorithm for abnormalities, 80t radiographs, 78 \200\22379, 80 screening for infection, malignancy and m etabolic bone disease, 81 slump test, 75f taking a history, 71 \200\22373 testing muscle st rength in managing, 535f lateral humeral epicondylitis/enthesitis, injection in, plate 14 le \202 unomide gut and hepatobiliary side oligoarticular pain, 163t effects, 229 pregnancy, 256 rheumatoid arthritis treatment of, 494, 495t lymph nodes, rheumatoid arthritis (RA), 240 lower limbs, 77t (RA), 251 systemic lupus treatment, 81 \200\22382 lymphomas lower leg and foot disorders radiographic features, 90t spinal tumors in children and adolescents, 551t lymphoproliferat ive disease, erythematosus (SLE), 347t (adults). See also foot disorders in children and adolescents anatomy, 118 \200\223121 ankl e and hindfoot leg disorders, treatment, 129 Sj gren \200\231s syndrome, 366 Legg \200\223Calv \200\223Perthes disease, 94, 470 \200\223471 examination, 125 \200\223126 bones and joints, 118 \200\223119 conditions of lower leg pain, pain radiation from M McArdle \200\231s disease, muscle back, 72 \200\22373 leukemia, spinal tumors in children and adolescents, 551t leukocytoclas tic vasculitis, 207t, 438, 439t pain/weakness, 192t leg, 121 McCune \200\223Albright developmental factors, syndrome, 473 McGill pain scale, 7t McKenzie exercises, low back pain, 539t McMurray \200 \231s test, meniscus damage, 112, 113f 121 diagnostic procedures, 127 \200\223129 limited cutaneous examination, 124 \200\223127 forefoot examination, CREST (calcinosis, Raynaud \200\231s, esophageal dysphagia, sclerodactyly, telangiectasia), 374 systemic scler osis, 377t 126 \200\223127 macular rashes, skin functional anatomy, 121 imaging lower leg, 127 imaging of foot, 127 \200\223128 intrinsic f oot structure, 120 joint/bursa \202 uid aspiration, 129 long muscles and disorders, 197 \200\223198 magnetic resonance (MR) detecting sacroiliitis, 286 elbow pain, 38 hand and wrist disorders, linear sclerosis, skin thickening, 199, 201t lipodermatosclerosis, 201t, 54 \200\22355 376t knee pain, 115 low back pain, 79, 81 myopathies, 406 neck pain, 19, 20f oligoarticular pain s, 159, live attenuated rubella vaccines, 165 liver, systemic sclerosis, tendons, 119 \200\223120 lower lumbar nerve root lesions, 128t 389t midfoot lesions, 126 neuroanatomy, 120 neurophysiology, 128 observation, 124 patient walkin g in bare lobular panniculitis, 508 \200\223509 locking 167 \200\223168 osteoarthritis, 266 pelvic, groin and thigh elbow, 35 \200\22336 knee, 108 \200\223109 pain, 101 long thoracic nerve, upper feet, 125 scan of neck, plate 1 shoulder pain, 31 \200\22332 thoracic back and chest limb, 58, 62f possible causes of low back pain and disorders in adults. See also back pain forefoot pain, 123 \200\223124 possible causes of pain, 69 hindfoot pain, 122, 123t widespread pain, 193 \200\223194 basic principles of possible causes of magnetic resonance assessment, 70 \200\22371 common and/or serious midfoot pain, 122 \200\223123 imaging/angiography (MRI/MRA), Takayasu \200\231s arteritis (TA), 422 radiographs, 127 \200\223128 steroid injections, 129 \200\223130 surgery, 130 taking a hist ory, 121 \200\223124 treatment, 129 \200\223130 low-trauma fracture. See osteoporosis lumba r disc prolapse, causes, 71t diagnostic procedures, magnet therapy, 558 malignancy 78 \200\22381 examination, 74 \200\22376 identifying lumbar nerve clues leading suspicion of, 230 root lesions, 78t monoarticular/ lumbar and sacral spine oligoarticular pain, 163t myopathy and links with, anatomy, 70 pain radiation and surgical approaches, 540, 541t 231t symptoms in legs, 72 \200\22373 lumbar nerve root lesions, nonmyopathic abnormal \201 ndings, 128t paraneoplastic syndromes, 232 osteoporosis, 449 previous trauma, lupus pernio, bluish-red or swelling of nose, plate 19 occupation and family history, 73 INDEX 586 rheumatoid arthritis (RA), myalgias, 173 malignancy (Cont.) paraneoplastic 250 \200\223251 widespread pain, 179 \200\223181 SAPHO (synovitis, acne, pustulosis, hyperostosis, and osteitis), 304 \200\223305 myasthenia gravis (MG) myopathies, 230 polymyositis (PM) and dermatomyositis (DM), 401 antinuclear antibodies (ANA), 184t myopathy and systemic lupus malignancy, 231t mycobacterial infection, atypical, 491 primary and secondary neoplastic diseases of bone and joints, 230 erythematosus (SLE), 347t methotrexate-induced pneumonitis, 576 methylprednisolone acetate, mycobacterium tuberculosis, rheumatic disease, 490 \200\223491 230 \200\223232 Mycobacterium tuberculosis, systemic sclerosis, 388 vasculitis, 203t widespread pain, 184 \200\223185 injection therapy, 142 66 microscopic polyangiitis mycophenolate mofetil (MPA), 434, 435t (MMF) malignant hyperthermia, midfoot polymyositis (PM) and dermatomyositis (DM), 411 systemic lupus muscle pain/weakness, 192t manipulation examination, 126, 137 possible causes of pain, 122 \200\223123 low back pain, 539t spinal, 556 migratory arthritis, 156 mitochondrial myopathies, muscle pain/weakness, 192t erythematosus (SLE), 345, 347t Marfan, Ehlers \200\223Danlos, myeloma, radiographic features, 90t gut and hepatobiliary manifestations, 227t monoarticular pains, adults, myocardial infarction, chest Marfan syndrome, collagen disorder, 474 \200\223475 medial humeral epicondyle, 150 pain, 65t myocardium, cardiac involvement in rheumatic disease, 210 \200\223211 morphea, skin thickening, 199, 201t 37 mortality, systemic lupus median nerve, upper limb, erythematosus (SLE), 348 60 \200\22361, 62f myopathy mediastinal conditions, chest Morton \200\231s metatarsalgia, differential diagnosis of, pain, 65t medicine. See 123, 133 406, 408t paraneoplastic, 230 screening examination for complementary and alternative medicine (CAM) motor neuron disease (MND), 179 proximal, 182f multicentric myositis, polymyositis (PM) and dermatomyositis (DM), 400 meniscus damage, dynamic test, 112, 113f, 114 metabolic bone diseases \201 brous dysplasi a, 473 osteochondritis and osteonecrosis, 470 \200\223472 reticulohistiocytosis, 510, 512 \200\223513, plate 16 multiple myeloma, 71t muscle activation tests, pelvic and hip pain, 99 muscle biopsy, widespread N nailfold capillaries pain, 183 abnormal capillary loops, osteochondritis dissecans, muscles plate 21 472 anatomy of pelvic normal capillary loops, osteoid osteoma, musculature, 92 \200\22393 characteristics of rare inherited causes of pain, 192t sarcoidos is, 505 shoulder, 24f testing shoulder girdle plate 20 472 \200\223473 navicular osteochondritis, osteomalacia and rickets, 135t neck pain 454 \200\223457 osteoporosis, 444 \200\223453 Paget \200\231s disease of bone, acute, with trauma, 16 diagnostic procedures, 466 \200\223468 18 \200\22319 parathyroid disease and related disorders, 458 \200\223464 metabolic disorders, childhood, 188t metastases, radiographic features, 90t metatarsal head muscles, 29t epidemiology, 14 examination, 18 functional anatomy, widespread pain, 173, 194 muscular dystrophies, 176t childhood disorder, 188t 14, 16f musculoskeletal features Beh et \200\231s disease, 501 malignancy, 230 sarcoidosis, 504 \200\223505 systemic lupus major causes of, in adults, 15t nerve root lesions, 14, 16f neurologic symptoms, 17 new and/or associated osteochondritis, 135t methotrexate erythematosus (SLE), 334 symptoms, 17 gut and hepatobiliary side occupational and leisure effects, 229 Takayasu \200\231s arteritis activities, 17 previous trauma, 17 radiographs, 18 \200\22319 taking a history, 14, 16 polymyositis (PM) and dermatomyositis (DM), 410 pregnancy, 256 (TA), 422 musculoskeletal lesions. See upper limb musculoskeletal lesions INDEX 587 Sweet \200\231s syndrome, 510, age, sex and occupation, treatment, 19, 20f 511t 154 necrotizing myopathy, 413 needle arthrocentesis/ olecranon bursocentesis, elbow pain, 38 nodal generalized background, 152, 154 characteristics of joint osteoarthritis, 264 nodules, joint diseases, \202 uid, 159t plate 16 common causes, 153t crystal arthritides, 155 diagnostic procedures, nongonococcal arthritides clinical features, 487t nongonococcal septic arthritis, 150, 167 Neer test, subacromial impingement, 30f 158 \200\223160 neonatal systemic lupus examination, 156 \200\223157 family and social history, erythematosus (SLE), 350 pyogenic, 486 \200\223488 non-Hodgkin \200\231s lymphoma, rheumatic disease and, 232 nonleukocytoclastic (lymphocytic ) vasculitis, 439t, 441 156 neoplastic diseases, primary and secondary, of bone and joints, 230 nephritis, 217 \200\223 218, 336, joint aspiration, 158 laboratory tests, 159 \200\223160 link with infection, 155 \200\223156 344, 365 magnetic resonance SLE (systemic lupus nonmyopathic (MR), 159 erythematosus), 568, 569t paraneoplastic syndromes, 232 radiographs, 158 \200\223159 skin rashes and SLE \200\223 pediatric, 571, 572f nonsteroidal anti- in \202 ammation, 157 synovial biopsy, 160 taking a history, 154 \200\223156 nephrogenic \201 brosing dermopathy, 376t nephrogenic systemic in \202 ammatory drugs (NSAIDs) adverse actions of, 252t ankylosing spondylitis oligoarticular pains in children and adolescents, 162 \200\223168 \201 brosis (NSF), scleroderma-like \201 brosing disorder, 394 (AS), 294 \200\223295 back pain, 540 enteric arthropathy, 302 \201 bromyalgia, 526 gout, 274 gut and hepatobili ary side background, 162 computed tomography nerve irritation, thoracic spine and chest wall, 66t (CT), 167 diagnostic procedures, nerve lesions. See upper 166 \200\223168 limb peripheral nerve lesions epidemiology, 163 examination, 165 \200\223166 infection/malignancy, 164 joint aspiration, 166 \200\223167 laboratory tests, 168 magnetic resonance (MR), 167 \200\223168 major causes , 163t musculoskeletal effects, 229 osteoarthritis, 269 psoriatic arthritis, 297 reactive arthropathy, 301 rheumat oid arthritis nerve pain, quality and distribution of, 96 nervous system systemic sclerosis, 389t systemic lupus (RA), 247 erythematosus (SLE), 337 systemic arthritis, 320 systemic lupus Wegener \200\231s erythematosus (SLE), 347t examination, 166 granulomatosis (WG), 432 radiographs, 167 scintigraphy, 167 skin rashes and nontraumatic vertebral neuroanatomy, femoral collapse evaluation, 542 treatment, 542 \200\223543 nerve, 93 in \202 ammation, 166 symptoms, 164, 165 synovial biopsy, 168 synovitis/enthesitis in neurogenic atrophies, childhood, 188t neurological involvement Beh et \200\231s disease, 502 rheumatoid arthriti s (RA), nose, lupus pernio as bluish- red or swelling of, plate 19 joint, 166 taking a history, 163 \200\223165 trauma, 164 ultrasound, 167 241 \200\223242 O Ober \200\231s test, meniscus damage, 112, 114 neurologic conditions, wrist and hand, 42t neuromuscular disease, oncogenic osteomalacia, myopathy and malignancy, 230, 231t ocular involvement, Sj gren \200\231s syndrome, 366 rheumatoid arthritis (RA), 240 ophthalmic symptoms, widespread pain, 189 \200\223190 organ diseases, in neuromuscular scoliosis (NMS), 546 oligoarthritis clinical features, 312 \200\223314 diagnostic evaluation neurophysiology, lower leg and foot, 128 neutrophilic dermatoses, of, 314 rheumatoid arthritis (RA), 240 \200\223242, 241t Osgood \200\223Schlatter \200\231s disease , differential diagnosis 510 \200\223513 multicenter of, 315t juvenile idiopathic 471 ossi \201 cation, 464 osteoarthritis (OA) reticulohistiocytosis, 510, 512 \200\223513 noninfectious, 511t pyoderma gangrenosum, arthritis (JIA), 312 \200\223315 treatment, 314 \200\223315 oligoarticular pains in adults, clinical features of, 152 \200\223160 264 \200\223265 510, 512t INDEX 588 management of, and hypercalcemia, 458, 459t hypercalcemia in infancy and childhood, 459 parathyroid hormone osteoarthritis (OA) (Cont.) low-trauma fractures, 450 \200\223453 epidemiology and pathology, 262 \200\223263 erosive OA, 264 \200\223265 investigation of, 266 large joint OA , 265 management of, 268 \200\223269 natural history of, 265 nodal generalized OA, 264 nodu les associated with, metabolic bone disease, 444 \200\223453 resistant syndromes, 462 primary pathogenesis and classi \201 cation, 444, 445t, 446 \200\223449 prevention, 450 primary hyperparathyroidism, 460 \200\223461 renal osteodystrophy, hyperparathyroidism, 448 463 \200\223464 plate 16 secondary and tertiary oligoarticular joint pain, radiograph, 101 risk of osteoporotic fracture, 444t hyperparathyroidism, 461 153t radiographic-pathological correlates in, 263t risk factors, 262 \200\223263 secondary cause s of, 265t osteoblastoma, radiographic parathyroid hormone treatment of established resistant syndromes, 462 disease, 451 \200\223453 treatment pathways parvovirus B19, infection for postmenopausal women, 453f osteoporotic fracture, 71t osteosarcoma, radiographic with acute polyarthritis, 175t features, 90t osteochondritis patella bone disease, 470 \200\223472 foot disorders, 135t osteochondritis dissecans, knee, 106, 107f patellar tap test for knee, features, 90t overlap/undifferentiated plate 11 472 autoimmune rheumatic disease, 375t pathology osteochondroma, antiphospholipid radiographic features, 90t syndrome (APS), 353 osteoarthritis, 262 \200\223263 Sj gren \200\231s syndrome, 362, osteogenesis imperfecta P Paget \200\231s disease, 71t, 94, 124, (OI), collagen disorder, 474, 475t 366 \200\223367 184, 185 pegloticase, gout, 275 Pellegrini \200\223Stieda osteoid osteoma, 472 \200\223473, clinical features of, 467t diagnosis and treatment 551t phenomenon, 106 pelvic, groin, and thigh pain radiographic features, 90t spinal tumors in children and adolescents, 551t of, 466 \200\223468 hand bones, 50 metabolic bone disease, anatomy, 92 \200\22394 bone scan, 101 causes of pain patterns, osteomalacia, 71t 466 \200\223468 classi \201 cation, 455t clinical and laboratory \201 ndings, 454 \200\223455 osteomyeli tis, 71t, 220 pain 95t assessment in children, 9 changes on examination, computed tomography (CT), 101 8 diagnostic procedures, diagnosis, 492 management of, 492, 493t treatment of, 492 localization of pain patterns, 6, 7t McGill pain scale, 7t pelvic, groin and thigh 100 \200\223102 distribution and type of bone and soft tissue pain, 94 \200\22395 osteonecrosis bone disease, 470 \200\223472 bone scintigraphy of left femoral head, plate 10 pain, 95t examination, 96 \200\22399 magnetic resonance quality, 6 panniculitis, 508 \200\223510 (MR), 101 osteopenia, 200, 444 osteoporosis, 85, 292 erythema nodosum (EN), muscle activation 508, 509t labular, 508 \200\223509 septal, 508 with vasculitis, 509 \200\223510 paraneoplas tic myopathies, malignancy, 230 tests, 99 bone mineral density observation and (BMD), 444 palpation, 96 \200\22398 calcium, 451 evaluation of, and quality and distribution of nerve pain, 96 radiographs, 100 risk factors for pelvic or low-trauma fracture, 449 \200\223450 exercise, 451 glucocorticoid-induced, (GIO), 448, 448t hormone replacement, parathyroid disease ectopic calci \201 cation and hip lesions, 98t surgery, 102 \200\223103 taking a history, 94 \200\22396 treatment, 102 \200\223103 ultrasound, 101 ossi \201 cation, 464 familial benign hypercalcemia (FBH), 461 451 hyperthyroidism, 449 hypogonadism, 449 idiopathic, 446 \200\223447 juvenile idiopathic (JIO ), familial hyperparathyroid peptic disease, chest pain, 65t periarticular disorders, wrist syndromes, 462 familial hypocalciuric and hand, 42t pericardial in \202 ammation, chest pain, 65t hypercalcemia (FHH), 461 447, 447t malignancy, 449 INDEX 589 corticosteroids for, 410 cutaneous disease, 400 drug-induced myopathy, primary pericardium, cardiac involvement in rheumatic disease, 210 hyperparathyroidism, 448, 460 \200\223461 412 primary vasculitides, 418 \200\223420 peritendinitis crepitans, 35 peroneal spastic \202 at foot syndrome, 137 epidemiology and diagnosis, 398, 399t extramuscular disease allergic (hypersensitivity) vasculitis, 438 pes cavus, 133t PET scanning, Takayasu \200\231s treatment, 411 gut and hepatobiliary ANCA (antineutrophil cytoplasmic antibody), 418, 419 arteritis (TA), 422 manifestations, 227t, 228t pharmacotherapy, ANCA-associated vasculitis (AAV), 435 \200\223437 rheumatoid arthritis (RA), 256 \200\223257 immunosuppressive agents, 410 \200\223411 phenylketonuria, 375t phosphate depletion, intravenous gammaglobulin Churg \200\223Strauss syndrome, (IVIg), 411 434 \200\223435 osteomalacia from, 456 \200\223457 physical therapy, 556 phytodolor, Populus tremula, investigation of, 404 juvenile PM (JPM), classi \201 cation of systemic vasculitis, 420t cryoglobulinemic vasculitis, 440 disease and damage assessment, 419 414 \200\223415 malignancy, 401 muscle biopsy, 404 prognosis in, 412 systemic manifestation s, 555 phytotherapy, 555 pigmented villonodular eosinophilic synovitis (PVNS), 518 401, 402t granulomatosis with polyangiitis (EGPA), 434 \200\223435 monoarticular/ treatment of, 410 \200\223412 Pompe \200\231s disease, muscle pain/weakness, 192t Populus t remula, phytodolor, oligoarticular pain, 163t oligoarticular pain in erythema elevatum adults, 152 diutinum (EED) and granuloma faciale (GF), 441 plantar fasciitis, 122, 129, 137, 156 555 plaques, skin disorders, 198 Plasmodium falciparum, 175 pleura, rheumatic disease, 214 pleu ritic in \202 ammation, chest posterolateral structures, hip and pelvis, 99 postmenopausal women, osteoporosis treatment, 453f giant cell arteritis (GCA), 424, 426 \200\223428 granulomatosis with polyangiitis, 430 \200\223432 pain, 65t Henoch \200\223Sch nlein purpura, 439 pneumonitis, methotrexate- postrenal azotemia, 216 \200\223217 post-streptococcal induced, 576 hypergammaglobulinemic POEMS (polyneuropathy, organomegaly, endocrinopathy, M-protein and skin changes), 376t poly arteritis, childhood vasculitis, 207t polyarteritis nodosa (PAN) antinuclear antibodies infection with acute polyarthritis, 175t purpura, 440 Kawasaki disease, 442 large-vessel vasculitis, 421 leukocytoclastic vasculitis, monoarticular/ oligoarticular pain, 163t, 165 438, 439t postsurgical back pain, microscopic polyangiitis 543, 543t posttraumatic carpal (MPA), 434 nonleukocytoclastic (lymphocytic) vasculitis, 439t, 441 polyarteritis nodosa instability, wrist, 44 (ANA), 184 t prednisolone acetate, gut and hepatobiliary injection therapy, 142 prednisone, systemic lupus erythematosus (SLE), 347t pregnancy manifestations, 228 t (PAN), 429 vasculitis, 429, 435t polymyalgia rheumatica, polyarthritis, 232 polyarthropathy, basic tests, 424, 425t, 427 small-vessel vasculitis, 181, 183 antiphospholipid 438 \200\223441 polychondritis, relapsing, (antibody) syndrome (APS) treatment in, 357t Takayasu \200\231s arteritis (TA), 516, 517t 422 \200\223423 polymyalgia rheumatica (PMR), 6, 96 drugs for RA, 256 \200\223257 fetal loss with APS, 354, urticarial vasculitis, 439 \200\223440 Wegener \200\231s conditions mimicking, 355t 425t rheumatoid arthritis (RA), granulomatosis, 430 \200\223432 diagnosis of, 424, 425t treatment of, 427 256 \200\223257 systemic lupus pseudogout, crystalline polymyositis (PM) erythematosus (SLE), 339 arthropathy, 150 pseudohypoparathyroidism antinuclear antibodies prerenal azotemia, 216 prevention, osteoporosis treatment, 450 primary biliary cirrhosis, r heumatic features, 226t (ANA), 184t autoantibodies in (PHP), 462 psoriatic arthritis myositis, 406, 407t clinical features of, classi \201 cation criteria for, 400 \200\223401 297, 298t INDEX 590 symptoms in the hand, psoriatic arthritis (Cont.) foot disorders in children 46 \200\22356 clinical features, 296 \200\223297 comparison to and adolescents, 139 \200\223140 thoracic back and chest pain, 64 \200\22369 rheumatoid arthritis, 297t gout diagnosis, 273 hand and wrist disorders, upper limb peripheral nerve lesions, 58 \200\22362 dactylitis, nail changes 53 \200\22354 wrist pain, 40 \200\22344 and DIP joint arthritis, plate 3 knee pain, 114, 115t low back pain, 78 \200\22379, 80 lower leg, 127 neck pain, 18 \200\223 19 oligoarticular pains, 158 \200\223159, 167 \200\223168 osteoarthritis, 262, 263t, rehabilitation acute mechanical back epidemiology, 296 \200\223297 juvenile, (JPsA), 306, pain, 538, 539t principles of, 146 \200\223147 relapsing polychondritis, 307, 325 monoarticular/ 516, 517t oligoarticular pain, 163t relaxation therapy, 558 renal disease, 71t 266 treatment of, 297 \200\223298 pain arising from bone, 50 pelvic, groin and thigh psychosocial history, Sj gren \200\231s syndrome, 365 systemic sclerosis, widespread pain, 174 pain, 100 pulmonary artery 387 \200\223388 shoulder pain, 31 spinal disorders in children, 89, 90t hypertension (PAH), 215 Wegener \200\231s granulomatosis (WG), 431 pulmonary disease renal involvement subacromial impingement Beh et \200\231s disease, 501 \200\223502 rheumatoid arthritis Beh et \200\231s disease, 502 renal crisis and syndrome, plate 2 thoracic back and chest (RA), 240 scleroderma, 575 pain, 68 \200\22369 Sj gren \200\231s syndrome, 365 systemic lupus systemic lupus widespread pain, 192 RAPID3 questionnaire, 246f rash. See skin rash rating scale, pain asse ssment erythematosus (SLE), 335 \200\223336 renal manifestations evaluation, 216 intrinsic renal f ailure, erythematosus (SLE), 335, 569, 570t systemic sclerosis, 384, in children, 9f 386t, 387 Wegener \200\231s Raynaud \200\231s phenomenon (RP), 197, 199, 374, 377t 217 \200\223218 granulomatosis (WG), 431 features of, 381 systemic sclerosis, 377t, postrenal azotemia, pulmonary \201 brosis, 214 pulmonary hypertension, scleroderma, 575 pulmonary manifestati ons 216 \200\223217 378 prerenal azotemia, 216 renal tubular acidosis, 218 rheumatic disease, treatment of, 383t reactive arthropathy airways, 215 interstitial lung disease, clinical presentation, 300 diagnosis and treatment 216 \200\223218 scleroderma renal crisis, 214 pleura, 214 pulmonary nodules/ of, 300 \200\223301 re \202 exology, 556 re \202 ex sympathetic 218 renal osteodystrophy, 456, 463t, 463 \200\223464 masses, 214 rheumatic disease, dystrophy, plate 5 renal pain, 84t renal tubular acidosis (RTA), regional musculoskeletal 214 \200\223215 vasculature, 215 systems 218, 457, 457t rheumatic disease, 150. corticosteroid injection therapy, 142 \200\223145 pulmonary nodules/masses, rheumatic disease, 214 pulmonary renal syndromes, See also infection and rheumatic disease cardiac manifestations, foot disorders in children and adolescents, 132 \200\223140 215 210 \200\223212 pustules and blisters, skin disorders, 198 pyoderma gangrenosum, general considerations, 12 knee pain, 104 \200\223117 low back pain and disorders endocrine manifestations, 220 \200\223223 gut and hepatobiliary manifestations, 224 \200\223229 510, 512t in adults, 70 \200\22382 lower leg and foot pyogenic joint infection, management of, 486 \200\223487 disorders, 118 \200\223130 malignancy, 230 \200\223232 pulmonary manifestations, neck pain, 14 \200\22320 pain around the elbow, 214 \200\223215 34 \200\22339 renal manifestations, R radial nerve, upper limb, pelvic, groin, and thigh 216 \200\223218 pain, 92 \200\223103 skin disorders and, 60, 62f radiographs rehabilitation principles, 196 \200\223200 146 \200\223147 skin vasculitis in adults, acute mechanical back shoulder pain, 22 \200\22333 spinal disorders 202 \200\223204 pain, 538 elbow pain, 38 foot, 127 \200\223128 skin vasculitis in children in children and adolescents, 84 \200\22390 and adolescents, 206 \200\223208 INDEX 591 surgery in, 257 rheumatic fever epidemiology and clinical rheumatoid factor negative clinical manifestations and treatment of, 496 \200\223497 presentation, 304 sarcoid, monoarticular/ polyarticular clinical manifestations, diagnosis of, 497 \200\223498 infection with acute polyarthritis, 175t revised Jones criter ia, oligoarticular pain, 163t 322 sarcoidosis juvenile idiopathic bones, 504 \200\223505 clinical manifestations, arthritis (JIA), 322 \200\223323 laboratory tests, 322 proposed 497t 505t diagnosis and treatment treatment, 498 rheumatic symptoms, Wegener \200\231s granulomatosis (WG), 432 subclassi \201 cation, 323t of, 505 \200\223506 treatment, 322 \200\223323 rheumatoid factor positive joints, 504 muscles, 505 musculoskeletal polyarticular childhood, 259 juvenile idiopathic manifestations, 504 \200\223505 rheumatoid arthritis (RA), 6 scalp, skin disorders, 196 Scheuermann \200\231s disease, 73, 84t, 89, 471t, 472 algorithm for arthritis (JIA), 324 rheumatologic emergencies management of adult RA, 258f acute hematologic Scheuermann \200\231s antinuclear antibodies manifestations of SLE (adults), 571 osteochondritis, 66t, 547 (ANA), 184 t anti-TNF-A therapy, acute SLE involving heart and lungs (adults), 569, 570t Schirmer \200\231s test, Sj gren \200\231s syndrome, 368 254 \200\223256 biologic agents, 252, 254 clinical features of, 239 comparison of psoriatic arthritis and, 297t sciatic nerve, 72 scintigraphy. See also bone acute SLE nephritis (adults), 568, 569t giant cell arteritis, 574 gonococcal (GC) septic ar thritis, 564 \200\223565 infections in patients taking anti-TNF-A drugs, 566, 567t methotre xate-induced pneumonitis, 576 pediatric SLE \200\223 acute hematological manifestations, 5 71, 573f scintigraphy Sj gren \200\231s syndrome, 368 disease activity scleredema, 375t assessment, 244 \200\223246 scleroderma-like \201 brosing disease criteria and disorder, 375t, 395 scleroderma, 374. See also systemic sclerosis and related disorders epidemiology, 236, 237t disease-modifying antirheumatic drugs (DMARDs), 249, 251 \200\223252, 253t crises, 575 cutaneous features of, drugs, 247 \200\223254 evaluation and treatment 380 \200\223381 diffuse skin changes, of, 244 \200\223258 380 \200\223381 pediatric SLE \200\223 acute nephritis, 571, 572f scleroderma crises, 575 septic arthritis , 562 \200\223565 severe vasculitis, 574 systemic vasculitis, 574 glucocorticoids, 248 \200\223249 gut and hepatobiliary manifestations, 227 t, 228t gut and hepatobiliary manifestations, 227t localized skin changes, 380 malignancy increase, 232 normal and irregular nailfold capillaries, plate 4 incidence, prevalence, and morbidity, 238 rickets, 84t le \202 unomide, 251 main components in treatment of, 248t management summary, 257 methotr exate, 250 \200\223251 nodules associated with, osteomalacia and, pulmonary hypertension, 454 \200\223457 575 rituximab renal crisis, 575 scleroderma-like \201 brosing disorders, 394 \200\223395 pregnancy, 257 rheumatoid arthritis (RA), 255 systemic lupus plate 16 scleroderma-like nonsteroidal anti- syndromes, 375 \200\223376t skin thickening, 199 \200\223200, erythematosus (SLE), 346 in \202 ammatory drugs (NSAIDs), 247 201t rol \201 ng, 559 rubella, infection with acute polyarthritis, 175t oligoarticular joint pain, scleroderma renal crisis, 218 scleromyxedema, 376t, 394 scoliosis, 68, 71t, 84t, 85, 87 153 t organ disease in, 240 \200\223242, 241t pharmacotherapy, causes, 86t congenital, 546 diagnosing, 89 \200\22390 idiopathic, 546 measurement by Cobb S sacroiliitis, 71t, 73 St. John \200\231s wort, 555 Salmonella, 155 SAPHO (Synovitis, Acne , 256 \200\223257 pregnancy, 256 \200\223257 rheumatoid factor positive polyarthritis in childhood, 259 sulfasalazine and method, 548f neuromuscular, 546 secondary amyloidosis, Pustulosis, Hyperostosis, and Osteitis) diagnosis and treatment, hydroxychloroquine, 249 \200\223250 rheumatoid arthritis (RA), 242 304 \200\223305 INDEX 592 stressing the skin disorders secondary hyperpara- thyroidism, 461 secondary malignant acromioclavicular joint, 28 \200\22329 diagnostic issues in patients with skin thickening, 199 \200\223200, 201t taking a history, 23, tumors, spinal tumors in children and adolescents, 551t secondary metastases, 71t septal pa nniculitis, 508, 509t septic arthritis 25 \200\22326 tests for subacromial face and ears, 196 \200\223197 hands and nails, 197 macular rashes, 197 \200\223198 plaques , 198 pustules and blisters, 198 scalp, 196 textural abnormalities, impingement, 28, 30f treatment, 32 \200\22333 visual inspection, 27 sialography, Sj gren \200\231s antibiotics for, 563t emergency, 562 \200\223565 gonococcal (GC), syndrome, 368 sickle cell crisis, 71t Simpli \201 ed Disease Activity Index (SDAI), 245 Si nding \200\223Larsen \200\223Johansson \200\231s disease, 471t, 472 199 564 \200\223565 types of eruption, immediate management of adult joint sepsis, 562, 563t, 564 197 \200\223199 ulcers and ulcerating rashes, 198 \200\223199 vascular lesions, 198 Sj gren \200\231s syndrome management, 486 \200\223487 monoarticular/ antinuclear antibodies (ANA), 184t skin rash oligoarticular pain, 163t autoimmune diseases, macular, 197 \200\223198 oligoarticular pains, oligoarticular joint pain, 367 153t cardiovascular system