joint pain

Question 1

ddx joint pain

Answer 1

Rheumatoid arthritis, osteoarthritis, meniscal tear (med/lat), tendonitis, (use–>)osteosarcoma, lupus, gout, bursitis, rheumatic fever (GAS), hip fracture, synovitis, septic arthritis (staph, gonorrhea), cong. hip dysplasia, slipped capital femoral, Paget’s disease, capsulitis, psoriasis, fibromylagias, med side effect

Question 2

80 yo obese man, chronic B/L knee pain 2 yrs duration

Answer 2

osteoarthritis

Question 3

55 yo woman 6 mod pain in hands, worse in morning (stiffness) “shakes it out after coffee”

Answer 3

rheumatoid arthritis

Question 4

Sjogren syndrome

Answer 4

autoimmune, dec. saliva production, joint pain

Question 5

important joints

Answer 5

knees, hips, hands/wrists, elbows, shoulders, TMJ, spine, feet/ankles

Question 6

most joints are

Answer 6

synovial

-freely moving articulations, enclosed by fibrous capsule, membranes secrete serous lubricating synovial fluid

Question 7

important questions for joint pain

Answer 7

Articular or extra-articular?
Single joint or multiple joints?
Joints inflamed or not?

Question 8

differences between rheumatoid and osteo

Answer 8

see chart

Question 9

RA/OA: lab findings

Answer 9

RA: elevated ESR and CRP
OA: normal

Question 10

Reactive arthritis

Answer 10

triad: “can’t pee, can’t see, can’t bend my knee”

HLA-B27+

Question 11

gout vs pseudogout

Answer 11

know observed diffs

Question 12

analyze synovial fluid for

Answer 12

WBC
Gs, Cx, sens
crystal ID by polarized microscopy (gout)

Question 13

RA tx

Answer 13

NSAIDS
Corticosteroids
DMARDS

Question 14

RA deformities

Answer 14

ulnar deviation, subluxation of MCP, swan neck, Boutonniere deformity

Question 15

pedagra?

Answer 15

“king’s disease”–>beer/meat–>gout