Msk Pattern Recognition

Front 1

OA or RA? Which joints?

Back 1

OA - PIP DIP wrist

NOT MCP

Front 2

OA or RA? Which joints?

Back 2

RA - MCP PIP wrist

NOT DIP

Front 3

OA or RA?

Back 3

OA - PIP and DIP

Front 4

OA or RA? What causes?

Back 4

OA - squaring of the thumb caused by the MCP joint subluxing radially

Front 5

OA or RA? What causes?

Back 5

OA - synovial fluid hypertrophy creates subchondular cysts

Front 6

OA or RA?

Back 6

RA - MCP and PIP

Front 7

OA or RA?

Back 7

RA - MCP and PIP

Front 8

OA or RA?

Back 8

RA - MCP involvement

Front 9

Name and describe this deformity - what disease is it seen in?

Back 9

Boutonniere in RA = PIP flexion and DIP hyperextension

Note - this is non-reducible because it is a product of erosion

Front 10

Name and describe this deformity - what disease is it seen in?

Back 10

Swan Neck in RA = PIP hyperextension and DIP flexion

Note - this is non-reducible because it is a product of erosion

Front 11

MCP subluxation seen in? Describe

Back 11

RA - ulnar finger deviation, Z-thumb

Front 12

What happened? Commonly seen in...

Back 12

MCP subluxation seen in RA

Front 13

Symmetric polyarthritis - disease? Clues?

Back 13

Psoriatic arthritis (seen in 25%) - note rash and DIP involvement

Front 14

Seen in 15% of Psoriatic arthritis - what is this?

Back 14

DIP disease (distal arthritis)

Front 15

Seen in 40% of Psoriatic arthritis - how do you describe this?

Back 15

Asymmetric oligoarthritis (<5 joints)

Front 16

Seen in 5% of Psoriatic arthritis - what is this called?

Back 16

Arthritis mutilans - deforming and destructive

Front 17

What is this characteristic of arthritis mutilans called, how does it happen and when is it seen?

Back 17

Telescoping digits seen in advanced psoriatic arthritis - collapsing of soft tissue secondary to bone resorption

Front 18

Three nail deformities seen in PsA?

Back 18

Pitting nails, onycholysis, hyperkeratotic nailbeds

Front 19

When and why does this happen? What is the early sign?

Back 19

MTP subluxation in RA - happens at all the toes (not just big toe) creating callouses as a protective mechanism

Early sign is toes spread apart due to swelling of MTP joints

Front 20

What is this extra-articular manifestation of RA - where are they commonly seen

Back 20

Rheumatoid nodules (starts from an inflammed vessel) - palpable, rubbery to firm nodules on extensor surfaces (those exposed to repetitive trauma) that can be painful with pressure

Front 21

What are these extra-articular manifestations of RA

Back 21

Scleritis

Scleromalacia perforans (thinning of the sclera)

Front 22

What is this pattern called and when is it seen?

Back 22

Ray = multiple joints in a linear distribution

Think spondyloarthropathies (psoriatic and reactive arthritis)

Front 23

What is this pattern called and when is it seen?

Back 23

Ray = multiple joints in a linear distribution

Think spondyloarthropathies (psoriatic and reactive arthritis)

Front 24

What is this puffy finger pattern called and when is it seen?

Back 24

Sausage digit = dactylitis

Think spondyloarthropathies, sarcoid, sickle cell, TB

Front 25

What is this puffy finger pattern called and when is it seen? How do you know which this image is of?

Back 25

Sausage digit = dactylitis

Think spondyloarthropathies, sarcoid, sickle cell, TB

This image is of sarcoid because of the small skin nodules

Front 26

Puffy fingers of scleroderma - which phase is this?

Back 26

Early, edematous phase

Front 27

Puffy fingers of scleroderma - which phase is this?

Back 27

Late, indurated phase

Front 28

Puffy fingers - prayer sign indicates what?

Back 28

Diabetic stiff hand syndrome (cheiroarthropathy) caused by flexion contractions

Long standing DM1 and DM2

Front 29

Two diseases present here...

Back 29

Gout with inflammatory arthritis

Front 30

Skin pattern - what disease?

Back 30

Calcinosis associated with scleroderma

Front 31

Skin pattern - what disease?

Back 31

Fingerpad tophi in Gout