Rheumatoid Arthritis and Osteoarthritis MCQs

PL&TA are antagonist to each other as PL plantar flexes and TA dorsiflexes ankle joint. PB & PT are antagonist to each other as PB everts the foot and PT inverts the ankle joint. Reference - Manish Kumar Varshney 1 st edition page no 1242

The clinical presentation described, is characteristic of septic arthritis of knee joint. The best method for confirming the diagnosis is to aspirate the knee joint to look for pus. The process of joint aspiration is also called arthrocentesis. Option B- Arthroscopy, is incorrect because this study is not the initial step in diagnosis. Option C- Bone scan, is incorrect because this study is appropriate to nonspecifically localize areas of inflammation but cannot be used to distinguish infectious from sterile processes. Option D- CT scan, and Option (E), MRI, are incorrect because these studies are more sensitive for diagnosing osteomyelitis and periarticular abscesses. Reference- Maheshwari Ortho 5th edition, page no 170.

Triple deformity of knee consists of posterior subluxation of tibia, external rotation of tibia and flexion. The mnemonic ‘P ER F’ can be used to remember this. Triple deformity is classically seen in late stages of TB of knee joint. Rarely rheumatoid arthritis can also produce similar deformity. Reference: Apley’s System of Orthopaedics and Fractures, 8th Edition, Page Number-42.

The most common joint involved in various pathologies. Septic arthritis- Knee joint Gout- MP joint of great toe Pseudo gout- Knee joint Rheumatoid arthritis- Metacarpophalangeal joint Ankylosing spondylitis- Sacroiliac joint Osteoarthritis- Knee joint> Hip joint Senile osteoporosis- Vertebrae Paget’s disease- Pelvic bone > Femur > Vertebrae Osteochondritis dissecans Knee joint Reference- Essential Orthopedics Maheshwari 5 th edition page no 293

Septic arthritis- Knee joint Gout- MTP joint of great toe Pseudo gout- Knee joint Rheumatoid arthritis- Metacarpophalangeal joint Ankylosing spondylitis- Sacroiliac joint Osteoarthritis- Knee joint> Hip joint Senile osteoporosis- Vertebrae Paget’s disease- Pelvic bone > Femur > Vertebrae Osteochondritis dessicans- Knee joint Reference- Essential Orthopedics Maheshwari 5 th edition page no 293

When a child presents with hip pain and FABER deformity of the hip, there are 2 DDs - transient synovitis or septic arthritis. In this case, there is mild fever and only mild restriction of movements, so the diagnosis is transient synovitis of hip. In septic arthritis, there will be high grade fever and severe restriction of hip movements. Reference: J. Maheshwari's 5th Edition of Essential Orthopaedics page no. 181

Telescoping of hip is seen in unstable hip and not in coxa vara. Causes of telescopy can be DDH, Tom Smith arthritis, surgical excision of femoral head etc. Coxa vara is the condition characterized by a reduction in the neck shaft angle. Clinical features of coxa vara are Adduction, External rotation deformity Limitation of Abduction and Internal rotation Shortening Trendelenburg sign + Axis deviation Reference :Tachdjian's Pediatric Orthopaedics 5th edition page no. 667

Hong Kong procedure(Radical anterior decompression and spinal fusion): It is a radical anterior debridement of spine followed by removal of diseased vertebral body and bone grafting in the area of the removed body. It helps in early healing of the disease and prevents also a deformity in better way, but needs appropriate facilities. It is usually done in cervical spine TB. Reference: Maheshwari Essential Orthopedics, 7 th edition, Page no. 200.