MY LEG HURTS
Severe heel pain with the first few steps of the day. feels like walking on Pebbles
Plantar fasciitis
athletic middle aged male presents with: lateral elbow pain, worse with gripping and throwing, pinpoint pain on lateral epicondyle
tennis elbow
64 YO M presents with weight loss, fever. Chronic back, shoulder, and hip pain. Strength intact. Normocytic anemia. ESR >50. Normal CK. Dx?
PMR
T/F: Fluctuations in RF mirror disease activity in RA.
False; serial testing is NOT indicated. ESR does
Anti-smooth muscle Ab
Autoimmune hepatitis
Hx Knee OA. Worsened knee pain that wakes patient from sleep. Point tenderness on the inferomedial aspect of knee (4-6 cm below patella). Dx?
Pes anserine bursitis
Patient with RA presents with : swollen tender elbow, erythema and heat over the posterior portion of elbow, normal extension and flexion
olecranon bursitis
Hx HCV. Presents with malaise, arthralgias, paresthesias in both feet, scattered LAD. C3, C4 are decreased. Dx?
Cryoglobulinemic vasculitis
Symmetric arthritis + daycare worker =
Parvovirus B19 infection
(usually self-limited after 1-3 months)
Antihistone Ab
Drug-induced SLE
Patient lays carpet for a living. Painful, swollen knee. Erythema. Localized tenderness over the patella. Normal ROM. Dx?
Pre-patellar bursitis
Diabetic 50 year old patient presents with: chronic shoulder pain that limits overhead reach, gradual shoulder stiffness and decreased ROM, normal x-ray
adhesive capsulitis
38 YO F with fatigue, myalgias, mental fogginess, interrupted sleep, exercise intolerance. Normal CBC, CMP, TSH, ESR/CRP. Dx? First-line therapy?
Dx: Fibromyalgia
Tx: Exercise. CBT.
Explosive onset or severe flare-up of psoriatic arthritis should prompt testing for...
HIV
c-ANCA
Granulomatosis with polyangiitis
Hx RA + chronic knee effusion. Acute pain and swelling behind the knee. Soft, swollen area in the popliteal fossa. Dx?
Bakers cyst
Lateral shoulder pain that disrupts sleep and inhibits ROM, most intense 4 inches down outer arm, reduced active but normal passive shoulder ROM
sub acromial bursitis
Pain, swelling, limited ROM, vasomotor instability, skin changes, and patchy bone demineralization of the extremities. Typically follows an injury with persistence of pain... Dx?
Complex regional pain syndrome
What finding in the joint fluid is pathognomonic for gout?
Monosodium urate crystals (needle-shaped, negtaively birefringent crystals)
Anticentromere pattern of ANA
CREST syndrome
Hip pain on outer thigh, especially when lying flat. Point tenderness over the lateral hip. Normal gait + ROM. Normal XR. Dx?
Trochanteric bursitis
nocturnal paresthesia and pain of the first three fingers in someone with hypothyroidism
Carpal Tunnel Syndrome
Hx DM2, HLD, HTN. Takes Patient with DM2, HL, HTN on sitagliptin, atorvastatin, losartan. Complains of diffuse MSK pain and weakness. Labs show elevated AST, ALT, LDH, CPK. Dx?
Statin-induced myopathy
59 YO F with accelerated HTN + CKD. Hx Raynaud. BP 160/122. Cr is 5.4. Fingers appear tapered with smooth skin and ulcers on the fingertips. Dx? Mgmt?
Dx: Scleroderma renal crisis
Mgmt: Captopril, even in renal failure
p-ANCA (2)
1. Eosinophilic granulomatosis with polyangiitis
2. MPA