Rheumatology: rheumatoid arthritis, SLE, spondyloarthropathies, gout
General Medicine · MBBS
Study notes
Morning stiffness >1 hour in small hand joints — rheumatoid arthritis; methotrexate early prevents deformity. RA (symmetric small-joint polyarthritis — morning stiffness >1 hr, anti-CCP/RF positive, erosions): early DMARDs (methotrexate — anchor) prevent deformity; biologics (anti-TNF) for refractory. SLE (young women — malar rash, photosensitivity, nephritis — ANA positive: hydroxychloroquine + steroids + immunosuppressants). Ankylosing (HLA-B27 — sacroiliitis, bamboo spine: NSAIDs, anti-TNF, exercise). Gout (acute podagra — big toe: NSAIDs/colchicine; chronic — allopurinol; tophi). The hour-long stiffness is inflammatory — osteoarthritis loosens in minutes.
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