Comprehension Questions

22.11 A 72-year-old man develops severe pain and swelling in both knees, shortly after undergoing an abdominal hernia repair surgery. Physical examination shows warmth and swelling of both knees with large effusions. Arthrocentesis of the right knee reveals the presence of intracellular and extracellular weakly positive birefringent crystals in the synovial fluid. Gram stain is negative. Which is the most likely diagnosis C. Calcium oxalate deposition disease 22.2 A 65-year-old man with a...

Approach To Polyarticular Arthritis

Articular Manifestations

The first and most important step in evaluating a patient with polyarticular joint pain is determining whether or not synovitis arthritis is present, producing soft tissue swelling, joint effusion, tenderness, warmth of the joint, and limitation of both active and passive range of motion. If the only finding is pain without inflammatory changes, then the diagnostic considerations include noninflammatory diseases such as osteoarthritis OA , fibromyalgia, hypothyroidism. neuropathic pain, and...

Clinical Perals Of Ra

Rheumatoid arthritis is a chronic systemic inflammatory disorder characterized by the insidious onset of symmetric polyarthritis and extraarticular symptoms. Rheumatoid factor is found in the serum of 85 of patients with rheumatoid arthritis. In nearly all patients with rheumatoid arthritis, the wrist, metacarpophalangeal joints, and proximal interphalangeal joints are affected, whereas the distal interphalangeal joints are spared. Distal interphalangeal joints and large weight-bearing joints...