MSK Ddx

Question 1

What are the clinical features of nongonococcal septic arthritis?

Answer 1

monoarticular, inflammatory, infectious

subacute joint pain, knee, fever, progressive pain and disability, injection drug use

Question 2

What are the clinical features of gonococcal arthritis?

Answer 2

monoarticular, inflammatory, infectious

young, sexually active woman, fever, severe pain of wrist/hand/knee w/warmth and erythema diffusely over backs of hands, rash

Question 3

What are the clinical features of lyme disease?

Answer 3

monoarticular or polyarticular, inflammatory, infectious

acute, inflammatory knee pain, has been in endemic area, Hx of tick bite, rash, fever

Question 4

What are the clinical features of gout?

Answer 4

monoarticular, inflammatory, crystalline

older pts, acute and severe pain of 1st MTP, becomes unbearable w/in hrs, unable to place sheet over toe, warm, swollen, red MTP

Question 5

What are the clinical features of CPPD/pseudogout?

Answer 5

monoarticular, inflammatory, crystalline

older pts, acute flare (pseudogout) or degenerative arthritis w/suspicious radiographic findings, hyperparathyroidism

Question 6

What are the clinical features of OA?

Answer 6

monoarticular or polyarticular, non-inflammatory

older pts, chronic joint pain, stiffness, worse w/activity, improves w/rest, knees/hips/hands, bony enlargement w/o significant effusions, tenderness along joint lines, ↓ROM, XR findings

Question 7

What are the clinical features of RA?

Answer 7

polyarticular, inflammatory, rheumatologic

middle-aged pts, symmetric polyarthritis, painful, swollen hands, morning stiffness, wrists, MCP, PIP, anemia, RF, ACPA

Question 8

What are the clinical features of SLE?

Answer 8

polyarticular, inflammatory, rheumatologic

young woman, fatigue, arthritis of hands, Hx of pleuritis/undiagnosed anemia

Question 9

What are the clinical features of psoriatic arthritis?

Answer 9

polyarticular, inflammatory, rheumatologic

middle-aged pts w/psoriasis, joint pain, wrists, MCP, PIP, DIP, psoriatic nail changes

Question 10

What are the clinical features of parvovirus?

Answer 10

polyarticular, inflammatory, infectious

young pt in contact w/children, 10d after flu-like illness, macular rash, moderately severe arthralgias, upper extremities, ∅ fever

Question 11

What are the clinical features of reactive arthritis?

Answer 11

polyarticular, inflammatory, infectious

subacute, oligoarticular arthritis, involving knees, ankles, back, Hx of infection, symptoms of urethritis/conjunctivitis