Inflammatory Joint Conditions

Question 1

What is the differential diagnosis for an inflammatory joint condition?

Answer 1

It may be autoimmune e.g. RA, connective tissue disorder or spondyloarthritis (likely polyarthralgia), may be crystal arthropathy (monoarthralgia) or infection (monoarthralgia)

Question 2

If a condition is polyarthralgic with synovitis and has lasted longer than 6 weeks what is it likely to be?

Answer 2

Systemic rheumatic disease

Question 3

If a condition is polyarthralgic with synovitis and has lasted less than 6 weeks what is it likely to be?

Answer 3

Viral arthritis

Question 4

If a condition is polyarthralgic without synovitis and with tender points what is it likely to be?

Answer 4

Fibromyalgia

Question 5

If a condition is polyarthralgic without synovitis or tender points what is it likely to be?

Answer 5

Osteoarthritis, soft tissue disorder, hypothyroidism etc.

Question 6

What is the prevalence of rheumatoid arthritis?

Answer 6

387,000 adults (0.81% of population)

Question 7

What is the incidence of rheumatoid arthritis?

Answer 7

12,000 new cases per year

Question 8

What is the peak onset for rheumatoid arthritis?

Answer 8

20-50 years of age.

Question 9

How does gender affect the risk of developing rheumatoid arthritis?

Answer 9

Females are 3x more likely (3:1)

Question 10

What knee complications can occur due to rheumatoid arthritis?

Answer 10

Valgus deformity of the knee and Baker’s cyst

Question 11

What ocular complications can occur due to rheumatoid arthritis?

Answer 11

• Keratoconjunctivitis sicca (dry eyes)
• Scleritis and episcleritis (a serious inflammatory disease that affects the white outer coating of the eye)
• Scleromalacia perforans (necrotizing anterior scleritis)

Question 12

What neuromuscular complications can occur due to rheumatoid arthritis?

Answer 12

Muscles wasting and carpal tunnel syndrome (may occur in early disease)

Question 13

What systemic complications can occur due to rheumatoid arthritis?

Answer 13

IHD, reduced life expectancy and accelerated osteoporosis

Question 14

Name some examples of connective tissue diseases

Answer 14

Systemic lupus erythematosus, scleroderma, dermatomyositis

Question 15

What is scleroderma?

Answer 15

Long-term autoimmune disease that results in hardening of the skin

Question 16

What is dermatomyositis?

Answer 16

Rare connective tissue disease characterised by inflammation of the muscles and skin

Question 17

What is ankylosing spondylitis?

Answer 17

This condition is associated with onset of back discomfort before the age of 40 and tends to have an insidious onset with a duration greater than 3 months that is associated with morning stiffness and improvement with exercise. It has a strong genetic link to HLA-B27.

Question 18

What is reactive arthritis?

Answer 18

This is a seronegative asymmetric form of arthritis that occurs following urethritis, cervicitis or infectious diarrhoea. There Is a less strong association with HLA-B27 but individuals with this condition may go on to develop ankylosing spondylitis.

Question 19

What condition may those with reactive arthritis go on to develop?

Answer 19

An association with HLA-B27 but individuals with this condition may go on to develop ankylosing spondylitis.