Master Of Medicine

Osteoarthritis

• MC joint involved-Knee Joint
• Primary OA(idiopathic)
• Secondary OA(Trauma,metabolic etc)
• Joint mice,subchondral sclerosis,osteophyte formation,Joint space narrowing
• Heberdens nodes and Bouchards nodes.
• Bouchards——->PIP
• Heberdens——>DIP
• Mnemonic:bOuchards—>O for Osteoarthritis
• B Comes before H so B for PIP and H for DIP

Rheumatoid arthritis

• HLA DR4 association
• MC in women
• Synovial hypertrophy and granulation tissue formation over cartilage(Pannus)
• Symmetrical small Joint pains
• MCP and PIP involvement
• DIP never involved
• Swan neck deformity-Flexion at DIP and hyperextended PIP
• Boutonniere deformity-Flexed PIP
• Atlantoaxial subluxation

Psoriatic Arthritis

• DIP involvement
• Sausage digits
• Pencil in cup appearance

Gout

• MC in MEN
• Assymetric joint involvement
• Joint swollen,red,painful.
• Painful MTP joint of big toe-podagra
• Due to precipitation of monosodium urate crystals due to hyperuricemia.
• Gouty tophus
• Needle shaped negatively birefringent crystals

Pseudogout

• Calcium pyrophosphate crystals
• Basophilic rhomboid crystals
• Weakly positive birefringent
• Affects large joints,classically knee