Rheumatoid Arthritis Overview

A 40-year-old woman presents with morning stiffness and inflamed metacarpal-phalangeal joints. Pathology reveals pannus formation, osteoporosis, and subcutaneous nodules with central fibrinoid material surrounded by palisaded macrophages. What systemic disease is most likely?

A 58-year-old woman suffers a T-1 vertebral compression fracture. Radiography reveals loss of coarse cancellous bone, thin hollowed cortex, and normal serum electrolyte levels. What is the most appropriate diagnosis?

A 10-year-old boy has a malignant tumor in the upper metaphysis of the tibia. X-rays show a mottled appearance with streak-like densities. Which tumor is most likely?

A patient with bacterial endocarditis develops pain in the lower tibial epiphysis. A biopsy indicates bone trabeculae damage, but no osteocytes. What diagnosis is most likely?

A 55-year-old heavy smoker has a solitary radiolucent lesion of the sacrum, initially considered a primary bone tumor. Chest X-rays reveal bilateral cannonball lesions. What is the most likely diagnosis?

A 15-year-old boy has a solitary tumor composed of uniform cells in the intramedullary area of the tibia. Lymphoma or leukemia are initial differential diagnoses. A biopsy confirms a primary bone tumor, and the patient survives 5 years after radiation and chemotherapy. What is the appropriate diagnosis?

A patient with joint disease has a subcutaneous nodule, usually on the extensor surfaces, composed of a central zone of fibrinoid necrosis surrounded by palisaded macrophages. This nodule indicates what systemic disease?

A 52-year-old man develops bow-legs over 5 years. Histology reveals a mosaic pattern in bone, with prominent cement lines as well as increased osteoblastic and osteoclastic activity. Serum calcium and phosphorus levels are normal. What is the likeliest diagnosis?

Extracellular proteinaceous deposits associated with chronic infections, such as chronic osteomyelitis, are indicative of what condition?

Haematogenous dissemination of bacteria with direct penetration of bacteria into bone is the most common cause of what condition?

What Gram-positive bacteria commonly causes hematogenous osteomyelitis in prepubertal boys?

Serological measurement of rheumatoid factor is commonly seen in what form of arthritis?

Inadequate mineralization of newly formed bone matrix in children is a major component of what disease process?

Name a malignant bone tumour that commonly occurs in adolescents and is located in long bones around the knee.

Name the autosomal dominant disease characterized by multiple cartilaginous lesions in the long and short bones.

Pannus, synovial cell hyperplasia with lymphoid follicles in the proximal phalangeal joint tissue, and ankylosis of small joints are signs of what disease?

Primary osteoporosis is seen most commonly in women who are in what stage of life?

Subchondral osteosclerosis (eburnation) of the proximal tibia, fibrillation of articular cartilage, and osteophyte formation in a 58-year old obese woman with chronic pain around the knee suggests what diagnosis?

The presence of long, needle-shaped, negatively birefringent crystals in the fluid removed from the first tarso-metatarsal joint of a 50-year old man with hyperuricemia is diagnostic of what condition?

What tumor is seen in the 4th-6th decades and most commonly involves the axial skeleton?

Uncoupling of osteoblastic and osteoclastic activity leading to disorganized and excessive bone formation describes which disease?

What disease of bone usually affects the weight bearing joints of the elderly and is due to a progressive loss of articular cartilage over time?

Severe kyphosis of the spine, also known as Pott's disease of the spine, is attributed to what disease?

Which of the following diseases/conditions can result in secondary osteoporosis?

Name the disease that produces attenuation of bony trabeculae with a decrease in bone mass, a low bone mineral density and fragility fractures:

Name the disease process that produces bone pain, predisposition to bone fractures and is associated with anaemia, lowered immunity and kidney damage:

A biopsy from a bony lesion shows the presence of necrotizing granulomatous inflammation with epithelioid histiocytes and Langhans type giant cells. What is the most likely diagnosis?

Name 3 systemic (extra-articular) complications of rheumatoid arthritis:

Name the infectious micro-organism that commonly produces pyogenic osteomyelitis in sickle cell anaemia patients:

What metastatic tumour produces osteosclerotic deposits in the bones and commonly in the vertebral bodies when seen on radiographic examination/XRay's?

Which of the following conditions is LEAST likely to be associated with carpal tunnel syndrome?

A 60-year-old man presents with insidious onset of pain in the hip. Examination shows limited internal rotation and flexion. Radiographs reveal joint space narrowing, osteophytes and subchondral sclerosis. Serum calcium, phosphate and alkaline phosphatase levels are normal. What is the MOST likely diagnosis?

A 70-year-old woman with a long history of osteoarthritis develops sudden onset of redness, swelling and severe pain in her right knee. Joint aspiration reveals cloudy synovial fluid with a high white blood cell count and gram-positive cocci. What is the MOST appropriate initial treatment?

A 30-year-old man presents with acute onset of severe pain and swelling in his left great toe. He reports similar episodes in the past. Joint aspiration reveals needle-shaped, negatively birefringent crystals. Which of the following medications is MOST appropriate for long-term management of this condition?

A 25-year-old woman presents with symmetric joint pain involving her hands, wrists and feet. She also reports morning stiffness lasting more than an hour and fatigue. Physical examination reveals synovitis in multiple joints. Which of the following laboratory tests is MOST helpful in establishing the diagnosis?

A 45-year-old man with a known history of ankylosing spondylitis presents with progressive stiffness and pain in his lower back and hips. He also reports uveitis (inflammation of the eye). Which of the following is the MOST likely underlying mechanism?

A 65-year-old man has a history of chronic alcohol abuse. He develops sudden onset of severe pain in his left hip. Examination shows limited range of motion and tenderness. Magnetic resonance imaging (MRI) reveals avascular necrosis (AVN) of the femoral head. What is the MOST likely underlying cause of his AVN?

In the context of bone remodeling in Paget's disease, which of the following cellular dysfunctions most directly contributes to the disorganized mosaic pattern observed histologically?

Which aspect of tuberculous osteomyelitis (TB) pathogenesis primarily accounts for the formation of necrotizing granulomas observed in bone biopsies?

In the context of rheumatoid arthritis-associated vasculitis, which immunological mechanism is most directly implicated in the pathogenesis of systemic vascular damage?

During hematogenous osteomyelitis, what bacterial virulence mechanism is most critical for establishing infection within the bone marrow?

What is the primary mechanism by which kidney failure contributes to secondary osteoporosis?