Arthritis

Question 1

What are the 4 types of joint abnormalities?

Answer 1

Osteoarthritis
Rheumatoid Artheritis
Psoriatic arthritis
Gout

Question 2

What are the two types of joint examinations?

Answer 2

GALS - Gait, Arms, Legs and Spine

REMS - Regional Examination of the Musculoskeletal System. More specific

Question 3

How does rheumatoid arthritis present?

Answer 3

symmetrical
Rheumatoid nodules on bony areas (inc elbows) - soft
Z shaped thumb
Swan neck deformity - DIP hyperflexion with PIP hyperextension

Question 4

How does osteoarthritis present?

Answer 4

symmetrical
Heberden’s nodes - boney swellings on DIP
bouchard’s nodes - boney swellings on MIP

Question 5

What is osteoarthritis?

Answer 5

Disease of the synovial joints
active inflammation
slowly progressive destruction of the articular cartilage that affects the weight bearing joints and digits

Question 6

What conditions are linked to secondary osteoartheritis?

Answer 6

Congenital abnormal joint (slipped femoral epiphysis)
Trauma to a joint
Abnormal stresses on a joint (e.g. weight bearing demands of obesity, association with particular sports, occupations)
Previous inflammation
Neuropathic joints e.g. diabetes mellitus
Haemophilia - bleeding into the joints

Question 7

How does psoriatic arthritis present?

Answer 7

assymetrical
psoriasis - most common on elbow/knees/gluteal cleft
Telescoping/mutilating arthritis - can pull the shortened finger back to full length
Dactilitis - inflammation of the digits

Question 8

How does Stills disease present and was does it signify?

Answer 8

severe version of juvenile idiopathic arthritis in children
salmon-colored skin rash
fatigue
fever
splenomegaly

Question 9

What is a sign of diabetes mellitus?

Answer 9

‘prayer sign’ with hands - can’t put hands flat together

due to glycosilation of collagen

Question 10

What are zanthoma modules and in which condition does it show in?

Answer 10

fatty growths develop underneath the skin

hypercalcemia

Question 11

What is ankylosing spondylitis?

Answer 11

autoimmune inflammatory disease

hunchback

Question 12

What is rickets caused by and what are the signs?

Answer 12

Vit D deficiency
knees bow out - osteoarthritis
rickets rosary - ribs showing

Question 13

What is dermatomyositis and what are the signs?

Answer 13

skin rash and inflammation of muscles
heliotrope rash
Gi turns packages

Question 14

What should be investigated when a patient has dermatomyositis and are over 50?

Answer 14

ovarian/breast cancer

Question 15

What are the signs of scurvy?

Answer 15

perifollicular hemorrhage
Hemarthrosis - bleeding into the joint, can lead to knee swelling
Arachnodactyly - spider fingers

Question 16

What condition are associated with collagen problems?

Answer 16

Marfan’s syndrome
long arms
hyperelastic skin

Question 17

What is the difference between normal gout and pseudo gout?

Answer 17

calcium pyrophosphate crystals, not uric acid

Question 18

What are two signs for endocrine disease?

Answer 18

Acromegaly

Exophthalmos

Question 19

When do you get erythema nodosum, lupus pernio and lung fibrosis ?

Answer 19

sarcodosis