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Old 09-21-2012
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Arrow Gyrus Daily Questions; Internal Medicine #14

A 31-year-old woman presents to your clinic complaining of painful arthritis that is worse in the mornings when she wakes up. She was recently evaluated by an
ophthalmologist for uveitis in her right eye. A recent laboratory report shows an erythrocyte sedimentation rate of 48 mm/h. Which of the following will be helpful in distinguishing relapsing polychondritis from rheumatoid arthritis (RA)?

A. Arthritis associated with RA is nonerosive.
B. Eye inflammation is absent in relapsing polychondritis.
C. Relapsing polychondritis will not present with vasculitis.
D. Relapsing polychondritis will present with high-titer rheumatoid factor.
E. The arthritis of relapsing polychondritis is asymmetric
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As polychondritis after areas which include cartilage and vasculitis in few cases.
I would go with
B. Eye inflammation is absent in relapsing polychondritis


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B. Eye inflammation is absent in relapsing polychondritis.
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E. The arthritis of relapsing polychondritis is asymmetric
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The answer is E.
E. The arthritis of relapsing polychondritis is asymmetric

Eye inflammation (60% of cases) and arthritis (>70% of cases) can be suggestive of either rheumatoid arthritis or relapsing polychondritis. The arthritis associated with RA is typically erosive and symmetric, unlike that in relapsing polychondritis. Both conditions can present with vasculitis (15% in relapsing polychondritis). Rheumatoid factor is occasionally positive in relapsing polychondritis but is usually low titer when present. Saddle-nose deformity, which is present in 25% of patients with relapsing polychondritis, may be confused with Wegener’s granulomatosis.
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