Cedrick
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A 61 year old woman has a 10 year old history of progressive pain in the hips,knee and hands
she has symmetric swelling and formation of nodules in the distal interphalangeal joints of her hands and pain on movement of both knees
there is no increased warmth or tenderness
the most likely cause of her joint pain is ?
a.-gout
b.-lyme disease
c.-osteoarthritis
d.-pseudogout
e.-rhuematoid arthritis
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| reet
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C. osteoarthritis. ( pain on movement)
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| Cedrick
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yes
C.-osteoarthritis
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| sridevibandaru24
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C
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| robin082006
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I go with Rheumatoid arthritis
Here why I choose it:
-Symmetric
- Rheumatoid nodules's signs
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| study_ing
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distal joint involvement favor OA
they rnt rheumaoid nodules, they are Nodes ( can never remember whether u call em bouchard or herbenden in distal) due to osteophyte frmation
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| Diego Casali
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C for sure.
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| reet
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Actually ,, two things are more positive--
LONG PERIOD over months and years.
Pain on movement.
and also distal nodules are herbeden nodes
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| robin082006
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How about symmetric symptoms?
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| robin082006
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I read Goljan Rapid review pg 302 again and could't distinguish C and E in this question.
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| study_ing
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more hints at OA
A 61 year old woman
formation of nodules in the distal interphalangeal joints of her hands and pain on movement of both knees
there is no increased warmth or tenderness
only thing is symmetric favoring RA. the proximal joint is fa vored more in RA.
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| study_ing
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rheuamtoid nodules on extensor surfaces
not DIP where herbenden's (thanx reet... ) i think
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| mjl1717
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Cedrick wrote:
A 61 year old woman has a 10 year old history of progressive pain in the hips,knee and hands
she has symmetric swelling and formation of nodules in the distal interphalangeal joints of her hands and pain on movement of both knees
there is no increased warmth or tenderness
the most likely cause of her joint pain is ?
a.-gout
b.-lyme disease
c.-osteoarthritis
d.-pseudogout
e.-rhuematoid arthritis
Rheumatioid- I think rheumatoid if its symmetric and affects many joints. Bouchards nodes usually in PIP and MP joints. Pain greatest upon arising in the morniing. This is not a good q because mentioning the Heberdens nodes usually in the DIP in ostearthritis could be in either disease CONTRAIDICTS the essence of this question. To make this a good q suggesting rhematoid arthritis the author should have added words like {IgG affecting IgM} or sed. rate, or pannus formation or even multi systemic disease. Also rheumatoid is more likely about 2:1 in a female. But it makes for decent discussion.
Edited by mjl1717 on 07/09/06 - 12:42 AM
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| MRMAVERICK
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C
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| muzammil
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its c all the things go in favor of oa
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| tolito
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C.
RA is MCP and PIP Joints while OA is PIP and DIP joints. OA may be symetrical too.
problem started at age 51. RA should start earlier ie 35 - 45.
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| twesting2173
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i think its IgM againt IgG in RA, but i may be wrong.
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| ManuNastai
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the answer is C
those are Herberden nodules, carracteristic to OA (distal interphalangeal joints). Bouchard nodules (in the proximal IF joints) are carracteristic for RA
also, my friends, there is no inflamated joints! (which appear in RA)
a very helpfull hint would be if cedrick would have told us how long does the pain last after moving, in the morning (short in OA and long, over an hour or the whole day w/ RA)
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| Musuq
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C then
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| ashfaque
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amswer E in rhematoid marked leukocytosis rash joint involvement thrombocytopenia in R.A rash is maulopapular indicating use of steroid ointment
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| vallia
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for sure is osteoartritis
hints- age, pain, heberden nodes (DIP)
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| hatiifa
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Rh. arthritis would have apparrent redness, hotness and tenderness of joints, also pain would be more on waking up after rest not on motion. these are characteristics of OA. I'd go for C.
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| usmle4me
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Shall go with C
age ~50yrs
Pain on movement
No warmth or tenderness
Nodules in DIP
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