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Old 08-03-2011
podebrad's Avatar
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Post Q Joint Pain

A 35-year-old man comes to the office seeking treatment for one week of joint pain in his left knee and right ankle. On further questioning, he admits to soreness of his back, which is tolerable at this time. On physical examination, there is a moderate left-knee effusion and a swollen, tender, right ankle. There are also small pits in the fingernails. What other finding would help make a specific diagnosis?

(A) Positive HLA-B27 antigen
(B) Tender right Achilles tendon
(C) Narrowing and sclerosis of sacral ileac joint
(D) Silver, scaly patches on the extensor surface of forearm and scalp
(E) Spondylitis
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Old 08-03-2011
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Originally Posted by podebrad View Post
A 35-year-old man comes to the office seeking treatment for one week of joint pain in his left knee and right ankle. On further questioning, he admits to soreness of his back, which is tolerable at this time. On physical examination, there is a moderate left-knee effusion and a swollen, tender, right ankle. There are also small pits in the fingernails. What other finding would help make a specific diagnosis?

(A) Positive HLA-B27 antigen
(B) Tender right Achilles tendon
(C) Narrowing and sclerosis of sacral ileac joint
(D) Silver, scaly patches on the extensor surface of forearm and scalp
(E) Spondylitis


Answer is psoriasis due to pitted nails so it is D.

Option A is present with Ankylosing spondylitis which usually present with sacroiliac joint involve ment and does not present with effusion.

Tender rt achillies also seen in ankylosing ....

Narrowing and sclerosis, effusion, seen in osteoarthritis

spondylitis usually involves spine.
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