Term
| A 35-year old male presents with low back pain and left heel pain. On examination, there is decreased lumbar flexion, extension and lateral bending. He is HLA B27+ and x-ray of his spine shows a bamboo spine with blurring of both sacroiliac joints. |
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| A 55-year old male presents with recurrent left knee pain. On examination, the left knee is mildly swollen and tender. X-ray of the left knee shows linear intra-articular calcification. Joint aspiration reveals positively-birefringent rhomboid crystals when viewed with polarized light. |
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Definition
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| A 35-year old male presents with pain in the knees and ankles. He also suffers from Crohn’s Disease. On examination, both knee and the right ankle are swollen, tender and slightly warm. The Rheumatoid Factor is negative. |
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| A 19-year old sexually-active male presents with severe knee pain and fever. There was no previous trauma. He does not use intravenous drugs. On examination, his left knee is swollen, hot and extremely tender. Joint aspiration shows numerous Gram negative diplococci. |
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| A 56-year old male presents with sudden onset of severe pain in his left big toe. On examination, the first metatarsophalangeal joint is swollen, shiny red, warm and tender. Aspirated synovial fluid reveals needle-shaped negatively-birefringent crystals when viewed with polarized light. |
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| A 15-year old teen complains of a mild fever and joint pains after camping in the nearby woods in Connecticut. On examination, there is erythema chronicum migrans. Blood tests confirm the presence of Borrelia antibodies. |
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Definition
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| An overweight 67-year old female presents with left knee pain that is worse at the end of the day. On examination, there is marked deformity of the left knee joint with crepitus. X-ray of the knee shows marked joint space narrowing, subchondral sclerosis and osteophytes mainly on the medial aspect of the joint. |
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Definition
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| A 43-year old overweight female presents with painful fingers. She also has a rash on the back of her elbows and front of her knees. On examination, there is pitting of her nails and plaques of silvery scales on her elbows and knees. Her fingers are swollen and tender. Her Rheumatoid Factor is negative. X-ray of her fingers shows a pencil and cup deformity of her DIP joints. |
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Definition
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| A 23-year old sexually active male presents with pain in his right eye and left ankle. Two weeks ago he had dysuria and a mucoid penile discharge. On examination, the right eye is red and the left ankle is swollen, warm and tender. A test for Chlamydia is positive. |
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Definition
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| A 10-year old child presents with fever and migratory joint pains three weeks after a sore throat. On examination, the right elbow joint is mildly swollen, warm and tender. There is a soft systolic murmur heard best in the 5th left intercostal space in the midclavicular line. There is no skin rash. The ASOT is positive. |
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Definition
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| A 23-year old female presents with painful joints in both of her hands with stiffness in the morning which lasts more than 1 hour. On examination, her PIP, MCP and wrist joints in both hands are swollen and tender. The Rheumatoid Factor is positive. X-ray of her hands show soft tissue swelling and juxta-articular bony erosions. |
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Definition
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| A 21-year old black female complains of joint pains and fatigue. She also has Raynaud’s phenomenon. On examination, there is a butterfly rash on her face. Her DIP and PIP joints are swollen. The ANA and anti-ds DNA antibodies are positive. |
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Definition
| Systemic Lupus Erythematosus |
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