Hand eteaching Rheumatoid arthritis 31032023

This joint is included for assessment according to ACR/EULAR criteria for Rheumatoid Arthritis.

• Left index finger DIPJ

• Left ring finger DIPJ

• Left first CMCJ

• Left first MTPJ

• Left first MCPJ

Answer explanation

DIPJs, first CMCJs and first MTPJs are excluded from assessment

What is Vaughan-Jackson syndrome?

• RA with splenomegaly and leukopenia

• Acute onset RA with fever, rash and splenomegaly

• Autoimmune condition that affects exocrine glands

• Extensor tendon attrition and rupture due to prominent dorsal ulna head

• Rupture of FPL in carpal tunnel due to scaphoid spur

Answer explanation

A – Felty’s syndrome

B – Still’s disease

C – Sjogren’s syndrome

D – Correct answer

E – Mannerfelt syndrome

Which of the below is pathognomonic of rheumatoid arthritis?

• Rheumatoid nodules

• Boutonniere deformity

• Swan neck deformity

• Gameskeeper’s thumb

• Positive rheumatoid factor (RF)

Answer explanation

When present and histologically confirmed, rheumatoid nodules are pathognomonic

Which is the foremost priority in deciding on surgery for the patient?

• Deformity

• Pain

• Cosmesis

• Retard progression of deformity

• Patient request

All of the following are untrue except:-

• Surgeons are the primary team when it comes to managing rheumatoid arthritis

• Mental health rarely gets affected for someone with rheumatoid arthritis

• All forms of exercise will aggravate rheumatoid flare-ups

• There is no evidence to show that any particular diet improves or worsens rheumatoid arthritis

• Surgeries for rheumatoid deformities are increasing over time

Answer explanation

A – multidisciplinary approach

B – Mental health commonly affected (modify tasks, avoids stressors, support group)

C – gentle exercises when inflammation has resolved promotos ROM, function and dexterity

D – True

E – medical therapy advances have decreased the need for surgical deformity correction