Potpourri

Question 1

Osteoarthritis Major and Clinical Features

Answer 1

Degeneration of cartilage leads to joint damage - slowly hampers ADLs

Disease limited to the joint (one or several, more w/ age)

Can see osteophyte formation and creaking w/ motion

Question 2

Rheumatoid Arthritis Major and Clinical Features

Answer 2

AI disease that attacks synovium and soft tissues - see swelling and destruction of multiple joints

Generalized disease that results in multiple, swollen and painful joints

Usually starts w/ hands and feet and progresses proximally

Question 3

Gouty Arthritis Major and Clinical Features

Answer 3

Deposition of crystals leading to joint inflammation and damage

Recurrent attacks, often in the big toe (Podagra)

Red, hot swollen joint/skin sensitivity - multiple episodes which resolve over time

Question 4

Osteoarthritis Imaging

Answer 4

Joint space narrowing

Subchondral sclerosis

Osteophytes

Subchondral cysts

Question 5

Rheumatoid Arthritis Imaging

Answer 5

Joint space narrowing

Soft tissue swelling

Bony erosions

Osteopenia about joint

Question 6

Gouty Arthritis Imaging

Answer 6

See erosion and joint destruction late in disease

Question 7

Osteoarthritis and Rheumatoid arthritis features in the hands

Answer 7

Swelling: OA - hard, bony; RA - soft, warm, tender

Stiffness: OA - worse after use (PM); RA - worse after resting (AM)

Fingers: OA - DIP/PIP + nodes; RA - MP and PIP + deformity

Question 8

Lab work and Synovial Fluid - Osteoarthritis

Answer 8

Labs: Usually normal

Synovial fluid: clear fluid negative for crystals

Question 9

Lab work and Synovial Fluid - Rheumatoid Arthritis

Answer 9

Lab: Elevated ESR, CRP, RF, and ACCP

Synovial fluid: slightly/moderately turbid

Question 10

Lab work and Synovial Fluid - Gouty Arthritis

Answer 10

Labs: elevated uric acid

Synovial fluid: crystals (positive or negative), turbid with monosodium or calcium pyrophosphate dehydrate

Question 11

CREST Syndrome

Answer 11

Calcinosis

Raynaud’s Syndrome

Esophageal dysmotility

Sclerodactyly

Telangiectasia

Question 12

CREST Syndrome Diagnostic Labs

Answer 12

ANA 70-90% positive

ACA 70-85% sensitivity, very specific for CREST

Question 13

Systemic Sclerosis

Answer 13

Eosinophilia 100%

ANA 70-90%

Anti-Scl70 and Nucleolar

Rheumatoid factor 30%

Question 14

Sjogren’s Syndrome

Answer 14

Anti-Ro (SSA) - 90%

Anti-La (SSB) - 60%

Question 15

Mixed Connective Tissue Disorders (MCTD)

Answer 15

Low titer ANA

Nuclear RNP antibodies >95%

Question 16

Myositis

Answer 16

Dermatomyositis: ANA, ANti-PM-Scl, Increased CPK/Aldolase enzymes

Polymyositis: ANA, Anti-PM-Scl