Rheumatologic emergencies.

Abstract

True rheumatologic emergencies are rare but they do occur. In many cases, the initial assessment, diagnosis, and treatment will rest in the hands of the primary care physician. Most common is acute onset of inflammatory arthritis. Properly diagnosed, adequate to dramatic improvements are usual with appropriate treatment. No less pressing are the neurologic emergencies such as spinal stenosis, cauda equina syndrome, and GCA. Among these, the potential for neurologic complications is high, so prompt diagnosis and treatment are essential. Cervical spine involvement in RA is common; again, neurologic complications are possible. The role of mechanical stabilization via surgery is not as well delineated but should be considered in patients with intractable pain due to C1-C2 facet joint disease and those with progressive neurologic deficiencies.