Non-Inflammatory Arthritis
Infectious Arthritis
Autoimmune Arthritis
Miscellaneous
200
These nodules are found at the DIP joints in patients with osteoarthritis.
What are Heberden nodes?
200
This diagnostic procedure should be performed before starting antibiotics in a patient with suspected septic arthritis whenever possible.
What is arthrocentesis?
200
Unlike osteoarthritis, this inflammatory arthritis typically spares the DIP joints while affecting the MCP and PIP joints.
What is rheumatoid arthritis?
200
This crystal arthropathy is associated with chondrocalcinosis and positively birefringent rhomboid-shaped crystals.
What is CPPD (pseudogout)?
300
A 69-year-old woman presents with gradually worsening bilateral knee pain over the past 5 years. The pain is worse after walking long distances and climbing stairs but improves with rest. Morning stiffness lasts about 10 minutes. Examination shows crepitus without warmth or erythema. Radiographs demonstrate asymmetric joint-space narrowing and osteophytes.
What is osteoarthritis?
300
A 26-year-old sexually active woman develops migratory wrist pain followed by swelling of her left knee. Examination reveals several painless pustules on her palms and tenderness over the extensor tendons of her hands.
What is disseminated gonococcal infection (gonococcal arthritis)?
300
A 42-year-old woman reports pain and swelling of both wrists, MCPs, and PIPs for the past 8 months. Morning stiffness lasts nearly 2 hours. Examination reveals symmetric synovitis. Laboratory testing demonstrates elevated ESR and positive anti-CCP antibodies. What is the most likely diagnosis?
What is rheumatoid arthritis?
300
A 57-year-old man presents with recurrent episodes of severe pain involving the first metatarsophalangeal joint. Examination demonstrates an erythematous, exquisitely tender joint. Arthrocentesis reveals needle-shaped negatively birefringent crystals. What is the most likely diagnosis?
What is gout?
400
A 58-year-old man with poorly controlled diabetes and severe peripheral neuropathy presents with progressive swelling of his right foot. Despite marked warmth and deformity, he reports very little pain. Radiographs demonstrate midfoot fragmentation and collapse.
What is Charcot (neuropathic) arthropathy?
400
A 68-year-old man underwent total knee replacement 2 months ago. He now presents with persistent pain, swelling, warmth, and decreased range of motion of the operative knee. ESR and CRP are elevated. Joint aspiration is most likely to grow which organism?
What is Staph Epidermidis?
400
A 24-year-old woman presents with several months of fatigue, symmetric pain involving the MCP and PIP joints, and morning stiffness lasting one hour. Examination reveals a rash that spares the nasolabial folds and painless oral ulcers. Urinalysis shows 3+ protein and red blood cell casts. Radiographs of the hands demonstrate no erosions. What is the most likely diagnosis?
What is systemic lupus erythematosus (SLE)?
400
A 54-year-old man presents with fatigue, arthralgias, and progressive pain involving the second and third MCP joints. Examination also reveals hepatomegaly. He was recently diagnosed with type 2 DM. Laboratory testing demonstrates elevated ferritin and transferrin saturation. What is the most likely diagnosis?
What is hereditary hemochromatosis?
500
A 45-year-old woman with systemic lupus erythematosus treated with prednisone for several years develops progressive right groin pain. Pain is reproduced with passive internal rotation. Hip radiographs are shown below. The most likely diagnosis is:
What is Avascular Necrosis of the femoral head?
500
A 64-year-old man presents with fever, severe knee pain, and inability to bear weight. Arthrocentesis reveals 95,000 WBC/mm³ with 94% neutrophils. Gram stain is negative. Blood cultures are pending. What is the next best step?
What is initiate empiric IV antibiotics for septic arthritis?
500
A 49-year-old woman presents with progressive "pulling" of the skin on her hands and worsening dysphagia to solids and liquids. Physical examination demonstrates sclerodactyly and digital ulcerations. Pulmonary function testing shows a restrictive pattern with decreased diffusion capacity. Which antibodies are most likely to be positive for this condition?
What are Anticentromere antibodies, Anti-topoisomerase-I (Anti-Scl-70), and Anti-RNA polymerase III?
500
A 73-year-old woman presents with several weeks of bilateral shoulder and hip joint stiffness that improves throughout the day. ESR is 105 mm/hr. Two days after starting prednisone, she develops a new unilateral headache, jaw pain while chewing, and transient loss of vision in one eye. What is the diagnosis and best next step in management?
What is giant cell arteritis requiring immediate high-dose glucocorticoids?