Acute Arthritis

Question 1

4 Types of acute monoarthritis

Answer 1

Septic joint
Crystal deposition- gout, pseudogout
Inflammatory vs. non inflammatory
Hemarthrosis- bleeding in joint

Question 2

Associated with disseminated gonococcemia septic arthritis

Answer 2

Pustules, tenosynovitis, dermatitis

Question 3

Risk factors for primary gout

Answer 3

Obesity, hyperlipidemia, diabetes mellitus, hypertension and artherosclerosis

Question 4

Risk factors from secondary gout

Answer 4

Alcoholism, drug therapy (diuretics, cytotoxics), myeloproliferative disorders, chronic renal failure

Question 5

Gout diagnosis

Answer 5

Synovial fluid evaluation showing urate crystals, needle shaped, strongly negative birefringent

Question 6

CPPD crystals deposition disease- associations and diagnosis

Answer 6

Pseudogout
Associated with hyperparathyroidism, hypercalcemia, hypocalciuria, hemochromatosis, hypothyroidism, gout, aging
Synovial fluid analysis for calcium pyrophosphate crystals that are rod or rhomboid shaped and weakly positive birefringent

Question 7

Pauci- or oligoarticular arthritis

Answer 7

2-4 joints with arthritis

Question 8

Polyarthritis defined as

Answer 8

More than 5 joints with arthritis

Infection or inflammatory grouping

Question 9

Infectious polyarthritis

Answer 9

Gonococcal, meningococcal, Lyme disease, rheumatic fever, bacterial endocarditis, viral (rubella, parvovirus, Hep. B)

Question 10

Inflammatory polyarthritis

Answer 10

Rheumatoid arthritis, Juvenile RA, SLE, reactive arthritis, psoriatic arthritis, polyarticular gout, sarcoid arthritis

Question 11

Temporal patterns in polyarthritis and examples

Answer 11

Migratory- rheumatic fever, gonoccocal (disseminated), early phase of Lyme disease
Additive pattern- RA, SLE, psoriasis
Intermittent- gout, reactive arthritis

Question 12

Patterns of joint involvement and examples

Answer 12

Symmetric polyarthritis of large and small joints- viral, RA, SLE, RA-like psoriatic arthritis
Asymmetric, oligo- and polyarthritis- involving mainly large joints, lower extremities: reactive arthritis, type of psoriatic, enteropathic arthritis
DIP joints- psoriatic

Question 13

Virus of ‘fifth disease’, erythema infectiosum
Slapped cheek appearance in kids, flu-like symptoms in adults with maculopapular rash on extremities
Acute onset symmetric polyarthralgia or polyarthritis

Answer 13

Parvovirus B-19

Question 14

“German measles” with arthritis in 1/3, morbilliform rash, constitutional symptoms, symmetric inflammatory arthritis of small and large joints

Answer 14

Rubella Arthritis

Question 15

Symmetric, inflammatory polyarthritis in large and small joints
Hand characteristically involved, acute hand deformity: fusiform swelling of fingers due to synovitis of PIPS
Presents acutely and develops beyond 2 months

Answer 15

Rheumatoid arthritis

Question 16

Musculoskeletal manifestations, arthralgia, acute inflammatory synovitis is RA-like, does not develop erosions
Malar rash, photosensitivity (can cause onset of symptoms), rashes between joints, alopecia, oral ulceration

Answer 16

Arthritis of SLE