Rheumatoid Arthritis Key Features
The patient presents with several classic signs pointing towards Rheumatoid Arthritis (RA):
- Age and Gender: A 40-year-old lady is within the typical demographic for RA onset.
- Symmetrical Involvement: RA commonly affects joints symmetrically on both sides of the body.
- Joint Distribution: Involvement of hands and fingers, specifically the metacarpophalangeal (MCP) joints, is characteristic.
- Stiffness Pattern: Stiffness that improves as the day progresses ("morning stiffness") is a hallmark of inflammatory arthritis like RA.
- Deformities: Progressive deformities, such as flexion and ulnar deviation at the MCP joints (ulnar drift), are typical findings in advanced RA.
Differential Diagnosis Comparison
Let's briefly consider why other options are less likely:
- Osteoarthritis (OA): Usually affects DIP and PIP joints, often asymmetrical, and stiffness typically worsens with activity, not improves.
- Ankylosing Spondylitis (AS): Primarily affects the spine and sacroiliac joints; significant hand deformities like this are uncommon.
- Tenosynovitis: While it can occur in RA, it represents inflammation of tendon sheaths, not the primary systemic joint disease described.
Conclusion: Rheumatoid Arthritis
Given the symmetrical polyarthritis affecting the small joints of the hands (MCPs), characteristic stiffness pattern, and specific deformities (ulnar deviation), Rheumatoid Arthritis is the most likely diagnosis.
Important Questions from Bones & Joints
- A 52-year-old female complains of increasing pain in the right shoulder. She is also finding it increasingly difficult to do overhead abduction of the affected joint. She had been diagnosed as a diabetic 20 years back and is on treatment since then. What is the most likely cause of her clinical condition?
Consider the following :
1. Pain relief
2. Prevention of infection
3. Anaesthesia
4. Restoration of anatomy
Which of the features given above are benefits of fracture treatment?
- Hangman's fracture is
- Which of the following is NOT true about Dupuytren's Contracture?
- Which of the following statements regarding the flat foot are true?
1. All children below 3 year have flat foot
2. 15% adult have flat foot
3. Painless flexible foot need no treatment
4. Rigid flat foot is a result of tarsal coalition
Select the correct answer using the code given below:
