Author Question: Your patient is a 55-year-old male who presents with sudden, severely tender, swollen, erythematous ... (Read 109 times)

NguyenJ · **on:** Jun 25, 2018

Your patient is a 55-year-old male who presents with sudden, severely tender, swollen, erythematous elbow. The patient reports that he experienced similar symptoms in the past.

You note the right elbow has a swollen, tender, soft 3 cm round nodule. The clinician should recognize these are signs and symptoms of:
A. Gouty arthritis
B. Rheumatoid arthritis
C. Epicondylitis
D. Reiter's syndrome

Question 2

A 46-year-old female complains of fatigue, general malaise, and pain and swelling in her hands that has gradually worsened over the last few weeks. She reports that pain, stiffness, and swelling of her hands are most severe in the morning.

On physical examination, you note swelling of the metacarpophalangeal joints bilaterally. These are common signs of:
A. Osteoarthritis
B. Rheumatoid arthritis
C. Scleroderma
D. Sarcoidosis

mtmmmmmk · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

ANS: A
Gout is a classic cause of monoarthritis, and most cases involve a joint in the lower extremities. Acute pain usually develops in one joint, with swelling, redness, and warmth, and the severity of the pain increases rapidly. ROM of the affected joint(s) is limited by pain, and there is significant tenderness to the site. Patients who have had gout for an extended time often have gouty tophi, which are soft tissue nodules containing urate crystals. The olecranon bursa is a common site for tophi development, and the tophi are often painful.

Answer to Question 2

ANS: B
RA typically affects the joints symmetrically. Symptoms may wax and wane, but the effects are cumulative and progressive. Although RA can affect any joint, it commonly affects the small joints of the hands and feet, and this is often helpful in diagnosis. There is often history of prolonged morning stiffness and fatigue. Affected joints are often tender, swollen with effusions, warm, and inflamed. The disease most commonly affects metacarpophalangeal and proximal interphalangeal joints.