USMLE Forum Archives - USMLE Step 3 - Rheum: Joint pains for days
Rheum: Joint pains for days
harry206 - 05-10-09 07:35
A 16-year-old Caucasian female presents to your office with a history of joint pain for several days. She complains of pain and morning stiffness in her small hand joints, wrists and knees. She has never had such symptoms before. She experienced a mild upper respiratory infection one week ago that resolved quickly. Otherwise, she has been healthy. She denies the use of tobacco, alcohol and illicit drug use. She is not allergic to any medication. She is not sexually active. Physical examination reveals mild symmetric swelling of her proximal interphalangeal and metacarpophalangeal joints; there is no warmth or joint effusion. Her complete blood count (CBC) with differential is normal. Her RF titers are slightly elevated.
Which of the following is the most likely diagnosis in this patient?
harry206 - 05-10-09 07:35
A 16-year-old Caucasian female presents to your office with a history of joint pain for several days. She complains of pain and morning stiffness in her small hand joints, wrists and knees. She has never had such symptoms before. She experienced a mild upper respiratory infection one week ago that resolved quickly. Otherwise, she has been healthy. She denies the use of tobacco, alcohol and illicit drug use. She is not allergic to any medication. She is not sexually active. Physical examination reveals mild symmetric swelling of her proximal interphalangeal and metacarpophalangeal joints; there is no warmth or joint effusion. Her complete blood count (CBC) with differential is normal. Her RF titers are slightly elevated.
Which of the following is the most likely diagnosis in this patient?
The correct answer and explanation will be available after you answer.
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#5
Re: Rheum: Joint pains for days conym5 - 06-18-09 06:48 My answer is: b.
hi harry this looks like very easy question,, but it's not .. my dx is between rheumatoid arthritis and rheumatic fever. I didnt find any major or minor criterias for rheumatic fever so I ll go with rheumatoid arthritis
#9
Re: Rheum: Joint pains for days sackatdoc - 06-20-09 18:57 RF factor is neither a sensitive nor specific test for rheumatoid arthritis, if q had ANA positive then answer would be different......but not with RF
#20
Re: Rheum: Joint pains for days conym5 - 04-18-10 09:06 pain and morning stiffness in her small hand joints, wrists and knees after upper respiratory infection can be viral arthritis..ral arthritis is mild requires only symptomatic treatment with analgesics or nonsteroidal anti-inflammatory drugs
#26
Re: Rheum: Joint pains for days babbu5508 - 08-31-10 04:52 My answer is: b.
i doubt between viral arthritis and rheumatoid...because the symptoms are present since several days, i would go with ra
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