Musculoskeletal disease

Definition

Q. What is arthritis?

Arthritis means inflammation of joint. Joint is hot, swollen, and tender.

Q. What do you mean by oligoarthritis?

Arthritis involving 2–4 joints.

Q. What is polyarthritis?

Arthritis involving 5 or more joints is called polyarthritis.

Q. What is arthralgia?

Arthralgia means painful joint. Joint is painful but not swollen and tender.

Monoarthritis

Q. An 18-year-old boy presents with painful swelling of left knee joint for 10 days. What is your diagnosis?

Monoarthritis of knee joint.

Oligoarthritis

Q. A 20-year-old man presents with painful swelling of both knee and right ankle joints for 2 weeks. What is your diagnosis?

Oligoarthritis is the diagnosis.

Q. What are the common causes of oligoarthritis?

Common causes are:

• • 1. Seronegative spondyloarthritis
       1. Reactive arthritis
       2. Psoriatic arthritis
       3. Ankylosing spondylitis
       4. Enteropathic arthritis.
    2. Osteoarthritis
    3. Juvenile idiopathic arthritis
    4. Oligoarticular presentation of polyarthritis, e.g. RA.

Polyarthritis

Q. A 35-year-old lady presents with painful swelling of metacarpophalangeal, proximal interphalangeal joints of both hands and small joints of both feet for 3 months. What is your diagnosis?

Symmetrical polyarthritis is the diagnosis.

Q. What are the causes of polyarthritis?

Causes are:

• • • Rheumatoid arthritis
    • Viral arthritis
    • Systemic lupus erythematosus (SLE)
    • Generalized osteoarthritis
    • Seronegative spondyloarthritis (psoriasis, reactive, ankylosing spondylitis, enteropathic arthropathy)
    • Chronic gout
    • Juvenile idiopathic arthritis.

Q. What are the causes of symmetrical polyarthritis?

Causes are:

• • • Rheumatoid arthritis
    • Viral arthritis
    • Systemic lupus erythematosus (SLE)
    • Generalized osteoarthritis
    • Juvenile idiopathic arthritis.

Q. Which arthritides are more common in female?

All inflammatory arthritides are common in female except ankylosing spondylitis, reactive arthritis and gout which are more common in male.

Connective tissue disorders

Q. What are the connective tissue disorders?

Connective tissue disorders are:

• • • Systemic lupus erythematosus
    • Systemic sclerosis
    • Dermatomyositis
    • Polymyositis.

Seronegative spondyloarthritis

Q. What are the types of seronegative spondyloarthritis?

Types are:

• • • Ankylosing spondylitis
    • Reactive arthritis, including Reiter’s syndrome
    • Psoriatic arthritis
    • Arthropathy associated with inflammatory bowel disease (enteropathic arthritis).

Q.  What are the diagnostic criteria for seronegative spondyloarthritis?

• 1. Asymmetrical inflammatory oligoarthritis (lower > upper limb)
  2. Sacroiliitis and/or inflammatory spondylitis
  3. Inflammatory enthesitis
  4. Anterior uveitis
  5. Tendency for familial aggregation (HLA B27)
  6. Persistently negative RF
  7. Absence of nodules and other extra-articular features of RA.