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Disease modifying antirheumatic drugs (DMARDs) such as methotrexate, sulfsalazine, and cyclosporin are used to control which MSK conditions? - Psoriatic arthritis, Rheumatoid arthritis, Reiter's syndrome, ankylosing spondylitis A male patient contracted chlamydia 1 month ago as well as inflammat...

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  • September 9, 2024
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  • 2024/2025
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NPLEX II - Orthopedics
Disease modifying antirheumatic drugs (DMARDs) such as methotrexate, sulfsalazine, and cyclosporin
are used to control which MSK conditions? - Psoriatic arthritis, Rheumatoid arthritis, Reiter's
syndrome, ankylosing spondylitis



A male patient contracted chlamydia 1 month ago as well as inflammatory diarrhea cultured with
campylobacter (gram - bacteria). He urgently makes an appointment as he is having joint pain that is
asymmetric involving his lower body and back, his eyes are red, and he is has dysuria and a lesion on his
glans penis (balantitis). What is this condition and how is it diagnosed? prognosis? - Reactive
arthritis (Reiter's syndrome)

No diagnostic test

CRP & ESR, HLA-B27, chlamydia NAAT

Self-limited - 3-12 months recovery



A man in his late 40s is experiencing a throbbing pain in his big toe (1st metatarsophalangeal jt) that is
swollen, erythematous, with limited mobility. He denies any injuries.

PMHx: HTN, DM II, and he is obese.

Meds: Hydrochlorothiazide

Diet is mainly meat, beer, and seafood.

What diagnosis do you suspect and which labs would you run? etiology? - Gout

Serum: uric acid

X-ray: tophii

Joint aspirate is most diagnostic



HTN meds, chronic dieases, diet, and unmodifiable risk factors (gender, age)



10 years ago you diagnosed psoriasis in a patient of yours. They have now come to you with a complaint
of swelling on the tips of their fingers that appear sausage shaped and with pitting in their nails. In
addition, they also have joint pain just on their left side. You suspect psoriatic arthritis. While there is no
diagnostic test, which tests can be done to strengthen your diagnosis? - CRP & ESR elevated

negative RF

, Which homeopathic remedy would be indicated for a case of gout with swelling of the feet that are >
with a tremendous desire to place feet in ice water? - Ledum



What are seronegative arthrotides? - Arthritic conditions that lacks RF and involves the axial
skeleton AND associated genetically with HLA-B27



When disseminated, Staph. aureus can wreak havoc on many systems in the body (endocarditis, for
example). How might it affect the joints and what would the condition be called? - septic arthritis
- usually affecting monoarticular joints - knee is most common, presenting with inflammation (red,
swelling, heat, and reduced ROM) + systemic inxn sxs (fever, leukocytosis)

Joint aspirate & if (+) treat immediately!



A male younger than 40 has been complaining of lower back pain with stiffness for the past 3 months.
He notices that it is worse in the morning, late at night, and with inactivity and that he must move
around often as this improves his symptoms.

physical exam: posterior pelvic tilt and loss of lumbar lordosis

You send for an X-ray, which reveals 'Bamboo spine" and is diagnostic of ankylosing spondylitis.

What are the complications/extra-articular manifestations of this condition? and which homeopathic is
best indicated? - Joint fusion

Uveitis

Aortic insufficiency

Restrictive lung diseases (in late stage dt costovertebral involvement preventing lungs from expanding)



Rhus Tox




What are 3 seronegative arthritides, with HLA-B27 and RF - - 1) Reactive arthritis (Reiter's
syndrome)

2) Psoriatic arthritis

3) Enteropathogenic (Crohns/UC, campylobacter, shigella, salmonella, yersinia)

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