Clinical Features Sample Clauses

Clinical Features. Most cases of RA develop insidiously over a few weeks to months. Patients often initially notice stiffness in the joints with associated pain on movement and tenderness to palpation of the affected joints. Although a few joints may be affected at onset, the disease is usually polyarticular and there is usually a sequential addition of involved joints. The small joints of the hands (metacarpophalangeal, proximal interphalangeal and wrist joints) and feet (metatarsophalangeal joints) are invariably involved, usually at an early stage. However, a smaller number of patients may present with a large joint onset of disease, in those that have a monoarticular onset, the knee is the most commonly affected joint. Occasionally patients have an acute or ‘explosive’ onset of symptoms over 24 to 48 hours. [Xxxx 1997] The stiffness associated with RA is characteristically worse in the mornings and lasts usually more than an hour but can last for several hours and its duration can be a useful gauge of disease activity. [Xxxxxxxxxxx et al. 2011] Although the stiffness in RA is most common in the morning, stiffness also commonly develops in the evenings and after long periods of inactivity, often referred to as ‘gelling’. This is in contrast to patients with degenerative arthritis who also have stiffness with inactivity but this usually only lasts for a few minutes.

Clinical Features. Early signs of erosive tooth wear include cupped out lesions on the occlusal surfaces of molars and translucency of the incisal edges of upper incisors as the enamel or dentine wears thin. Later, erosion of enamel and dentine may result in restorations appearing proud of the tooth surface and symptoms of sensitivity may result (Xxxxx, 1991). Attritional wear presents itself as flattening of inter-digitating cusp tips with wear facets seen in both arches as the occlusal aspects of the teeth contact in static and dynamic occlusions (Xxxxx, 1991). Abrasion manifests itself on the buccal-cervical areas as rounded, wide lesions usually on the incisors, canines and premolars (Xxxxx, 1991). Figure 1 below shows Intra-oral clinical photographs of a 36 year old male patient with severe tooth wear the aetiology of which included intrinsic erosion (from gastro-oesophageal reflux and vomiting) and attrition. Figure 1 Intra-oral clinical photographs of a 36 year old male patient with severe tooth wear‌