Arthritis

Question 1

Approach to young female

Answer 1

RA, SLE, fibromyalgia

Question 2

Approach to older female

Answer 2

OA, RA (bimodal presentation), polymyalgia rheumatica, gout

Question 3

Approach to young male

Answer 3

Reactive arthritis, RA, gout

Question 4

Approach to older male

Answer 4

OA, gout, pseudogout

Question 5

Lower extremity

Answer 5

HLAB27 related arthritis, gout

Question 6

Root joints

Answer 6

Polymyalgia rheumatica

Question 7

Symmetric small joint

Answer 7

RA, SLE

Question 8

Axial pain

Answer 8

HLAB27 related arthritis, tumor, infection

Question 9

1st MTP

Answer 9

Gout, bunion, pseudogout, reactive arthritis

Question 10

Unilateral inflamed wrist

Answer 10

Pseudogout

Question 11

1st CMJs, DIPs, hips, knees

Answer 11

Primary OA

Question 12

Primary osteoarthritis

Answer 12

Common in older males and females, typically in DIPs, PIPs, hips, knees (medial compartment), see hypertrophic changes in bone and bony spurs, loss of joint space and squared off bones

Question 13

Secondary osteoarthritis

Answer 13

Can be associated with disease, OA in atypical areas such as the ankles, wrists, MCPs, shoulders, or elbow, usually crystal induced (gout, pseudogout, basic calcium phosphate), see MCP hooks, chondrocalcinous, joint space loss without erosion, hypertrophic changes in bone

Question 14

Diffuse musculoskeletal pain syndrome

Answer 14

AKA fibromyalgia, diffuse pain involving muscle and joints seen often in young female patients, neuropathic pain symptomatology, associated with sleep disorders, absence of joint swelling, has to last at least 3 months for Dx

Question 15

Osteoarthritis treatment

Answer 15

NSAIDs, analgesics, injections, surgery

Question 16

Fibromyalgia treatment

Answer 16

Low dose tricyclics, cyclobenzaprine, duloxetine, lyrica, aerobic exercise, CPAP for patients with sleep apnea

Question 17

Lupus arthritis

Answer 17

Finger deformity present “swan neck”, no marginal erosions

Question 18

Rheumatoid arthritis

Answer 18

Marginal erosion, osteopenia (loss of bony calcium), loss of joint space, symmetric

Question 19

Septic arthritis

Answer 19

Acute arthritis with fever, unilateral swelling, sever pain, limited ROM, tap the joint immediately, typically caused by S. aureus