LG 3.4 Clin. Correlate Arthritis

Question 1

1. What test would you order first for someone with red hot joint pain?

Answer 1

Blood Cultures first, since you are suspecting infection will treat with abx, but need cultures before giving abx for accurate results and treatment

Aspirate the joint
-Diagnostic, and therapeutic to relieve pressure

Question 2

What are systemic risk factors for Infectious Arthritis?

Answer 2

1. Immunocompromised

2. IV drug user

Question 3

What are local risk factors for Infectious Arthritis?

Answer 3

1. Bites, thorn

2. Invasive procedure

Question 4

Who is at high risk for infectious arthritis?

Answer 4

1. Steroid therapy
2. Immunodeficiency
3. Diabetes
4. IV drug abuse
5. Other focus of infection (eg. UTI, pneumonia, etc.)

Question 5

What symptoms does someone with infectious arthritis have?

Answer 5

Resistive to Passive ROM,

Joint pain and swelling, fever

Question 6

What results would synovial fluid show if it was infectious arthritis?

Answer 6

Appearance -Cloudy and less viscious

Cell count- Leukocytes count 100,00/uL with 90% neutrophils

Question 7

Where does gout appear in 50% of initial episodes of gout?

Answer 7

1st metatarsophalangeal joint

Question 8

What are defining lab findings that diagnose gout?

Answer 8

Synovial-crystal (Monosodium urate crystals)

Question 9

What can cause a gout attack?

Answer 9

Trauma or medication change

Question 10

How long should someone with RA have morning stiffness?

Answer 10

> 1 hour. If it is less than an hour can’t be RA, most likely OA

Question 11

What features of RA differs from OA?

Answer 11

RA does not have distal interphalangeal deformity.

RA is symmetric while OA is not.

Question 12

What is the most common arthritis?

Answer 12

OA

Question 13

What is Heberden nodes?

Answer 13

It is deformity with the DIP, only seen in OA.

Question 14

Risk factors of OA

Answer 14

1. Age: primary RF for development of OA
2. Obesity: particularly knee and hand
3. Occupations
   
   • involve repetitive knee bending and physical labor
   • Farming, construction work
4. Female
5. Trauma

Question 15

What are the criteria for diagnosing OA of the knee?

Answer 15

1. Age > 50 years old
   
   2. Stiffness < 30 minutes
   3. Crepitus
   4. Bony tenderness
   5. Bony enlargement
   6. No palpable warmth
      Must have at least 3 of these to be diagnosed with OA.