Clinical - signs

Question 1

Sign? Dis & aetiology?

Answer 1

Fusiform swelling

eg. RA - synovitis of PIP & MCP jts

(Dactylitis is swelling whole finger)

Question 2

Sign? Dis & aetiology

Answer 2

Dactylitis

Swelling of a digit

Spondylarthopaties - PsA, Ank Spond, Reactive Arthritis

Can also see in gout 2** crystal deposition

Question 3

Sign? Dis & aetiology

Answer 3

Swan Neck deformity

Hyperextension at PIP joint, flexion at MCP & DIP joints

Question 4

Sign? Dis & Aetiollgy?

Answer 4

Boutinerres

Flexion PIP jt and hyperextension at MCP & DIP jts

Question 5

Sign? Dis & Aetiology?

Answer 5

Z deformity

Flexion at IP & hyperextion MCP jts

Question 6

Sign? Dis & aetiology?

Answer 6

Rheumatoid nodules

Firm, non tender (unlike olecranon bursa - fluid filled, tender, transilluminate)

DDx: gouty tophi, tendon xanthomata, cutaneous sarcoid, granuloma annulare

25% of pts w/ RA (sero positive)

Question 7

Nerve of hand - muscle & dermatome

Answer 7

• Median (C5-8)- palmar thumb & first fingers
• Ulnar (c8, T1)- palmar & dorsal little finger
• Radial C6-8) - high up arm then dorsal base of thumb
• C6: thumb
• C7: next two
• C8: little finger