CLINICAL ENCOUNTERS
RHEUMATOID ARTHRITIS
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Question
[CLICK ON ANY CHOICE TO KNOW THE RIGHT ANSWER]
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Decreased muscle strength
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It feels hot
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There is a tophi lump
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There is crepitation
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Increase in segment diameter
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Detailed explanation-1: -Tophi (plural of tophus, Latin for “stone”) are stone-like deposits of monosodium urate in the soft tissues, synovial tissues, or in bones near the joints. They are pathognomonic for gout, the most common inflammatory arthritis in the United States, with an estimated lifetime prevalence of 4%.
Detailed explanation-2: -PHYSICAL EXAMINATION In patients with chronic tophaceous gout, there may be whitish-yellow skin deposits, subcutaneous nodules, and areas of taut skin. The lower-extremity joints and tendons, as well as the wrists, fingers, and elbows, are commonly affected16 (see Figure 2).
Detailed explanation-3: -The gold standard for establishing a definite diagnosis of gout is the presence of MSU crystals in aspirated joint fluid or tophus.