Rheumatological Investigations

Question 1

DOCS mneumonic for X-rays:

What does it stand for?

Answer 1

Density
Bone (O)utline
Cortex and medulla
Soft tissue

Question 2

X-rays:

Density:

• What is increased bone density called?
• What is low bone density called?

Outline:

• What does uneven joint space narrowing suggest?
• What does even joint space narrowing suggest?
• What do erosions look like?
• What do cysts look like?
• What do osteophytes look like?

Answer 2

Osteopenia

Bone sclerosis

OA

RA

Holes

Holes with intact edges

Growth seen at the edge

Question 3

Joint aspiration:

What should you avoid doing an aspiration through?

Answer 3

Through potentially infected skin:

• Psoriatic skin
• Cellulitis