USMLE Forum Archives - USMLE Step 3 - Rheum- Morning stiffness
Rheum- Morning stiffness
harry206 - 05-10-09 10:10
A 45-year-old Caucasian female presents to the office because of progressive swelling, pain, and stiffness of the joints of her hand and wrist for the past several months. She says it takes hours to get some relief because her hands are so stiff in the early morning. Her past medical history is not insignificant. Her mother has a history of systemic lupus erythematous. Examination of her joints shows warmth, swelling, and tenderness of the proximal interphalangeal joints, metacarpophalangeal joints, and wrists.
X-ray of the hands shows periarticular osteopenia and erosions of proximal interphalangeal and metacarpophalangeal joints. Labs show negative ANA, negative anti dsDNA, and negative rheumatoid factor. Parvovirus titers show positive IgG. One week later, she comes back with good relief of the symptoms. Which of the following is the most appropriate next step in the management of this patient?
harry206 - 05-10-09 10:10
A 45-year-old Caucasian female presents to the office because of progressive swelling, pain, and stiffness of the joints of her hand and wrist for the past several months. She says it takes hours to get some relief because her hands are so stiff in the early morning. Her past medical history is not insignificant. Her mother has a history of systemic lupus erythematous. Examination of her joints shows warmth, swelling, and tenderness of the proximal interphalangeal joints, metacarpophalangeal joints, and wrists.
X-ray of the hands shows periarticular osteopenia and erosions of proximal interphalangeal and metacarpophalangeal joints. Labs show negative ANA, negative anti dsDNA, and negative rheumatoid factor. Parvovirus titers show positive IgG. One week later, she comes back with good relief of the symptoms. Which of the following is the most appropriate next step in the management of this patient?
The correct answer and explanation will be available after you answer.
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#1
Re: Rheum- Morning stiffness bingousmle - 05-10-09 13:29 My answer is: d.
if its the arthritis due to parvo virus infection that is causing her the trouble then it can be controlled with NSAIDS...
#20
Re: Rheum- Morning stiffness babbu5508 - 08-30-10 01:45 My answer is: d.
Tell her that she does not need additional treatment..as the arthritis is due to parvovirus and spontaneously resoves ust symptomatically treated with NSAID'...
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