Summary
Highlights
Kaplan syndrome (rheumatoid arthritis + pneumoconiosis) and Felty syndrome (rheumatoid arthritis + neutropenia + splenomegaly) are key associations with rheumatoid arthritis. Diagnostic tests range from anti-CCP (most specific) to ESR and CRP (least specific). Treatment involves DMARDs like methotrexate, with TNF-alpha inhibitors as a last resort after checking for latent TB.
Psoriatic arthritis is diagnosed with a positive HLA B27 and pencil-in-cup deformity; treatment is NSAIDs or methotrexate. Ankylosing Spondylitis, common in young males, also presents with positive HLA B27 but shows sacroiliitis or vertebral joint fusion on X-ray; treatment starts with physical therapy and NSAIDs.
A quick recap of the first line treatments for osteoarthritis, psoriatic arthritis, rheumatoid arthritis, ankylosing spondylitis, gout, and pseudogout. Quick hit scenarios are briefly covered for test taking purposes.
Septic arthritis diagnosis involves synovial fluid aspiration; treat with vancomycin even with a negative Gram stain. Late Lyme disease causes arthritis and encephalopathy; diagnose with ELISA and confirm with Western blot; treat with doxycycline or ceftriaxone based on severity.
Gonococcal arthritis presents with arthritis and pustules; treat with ceftriaxone and doxycycline. Cancers that commonly metastasize to bone (PRTLB: Prostate, Renal cell, Testes, Lung, Breast) with prostate cancer forming blastic lesions.
Scaphoid fractures require X-rays and possible MRI due to risk of avascular necrosis. Monteggia (ulnar) and Galeazzi (radial) fractures are discussed. Femur fractures can cause fat emboli, treat with supportive care. Colles' and Smith's fractures are different types of wrist fractures. Meniscus tears require NSAIDs and PT.
Cauda equina syndrome necessitates immediate surgery after MRI confirmation. Rotator cuff injuries, particularly supraspinatus, cause pain with active abduction; treat with RICE and physical therapy.
Acute gout is treated with NSAIDs, colchicine, or steroids; chronic gout with allopurinol or febuxostat. The video ends with general test-taking tips, such as fractures usually appearing on X-rays.