Polyarthritis Tutorial Flashcards
what is polyarthritis?
arthritis affecting more than 1 joint
differentials for RA?
psoriatic arthritis CT disease (esp. lupus)
investigations for RA?
anti-CCP, ESR, CRP
ultrasound
x ray
DAS score
how could you differentiate RA from psoriatic arthritis using autoantibodies?
RA has anti CCP, psoriatic is seronegative so won’t have any autoantibodies
how should you use ANA in clinical practice?
use its absence to rule out lupus
early presentation of inflammatory arthritis on x ray?
soft tissue swelling periarticular osteopenia (bone thinning)
what does osteopenia look like on x ray and why?
dark areas as thinner bone comes out darker and thicker is whiter
what would you expect to see on hand examination of someone with inflammatory arthritis?
swollen PIP and MCP joints
why is ultrasound a good investigation for RA?
picks up inflammation
late presentation of RA on x ray?
erosion
what would a low Hb and normal MCV indicate on FBC
anaemia of chronic disease
why is methotrexate the preferred DMARD
only have to take it once a week
works within 6 weeks- quicker than others
what treatment should be given in a severe flare up of arthritis
- add sulfasalazine
2. add biologic id DAS >5.1
when is the only time a biologic should be considered in arthritis
if DAS >5.1
how would you measure disease activity and response to treatment in a patient on a DMARD
DAS score