QuestionSBA
QuestionChoice
Although pseudogout can cause an inflammatory asymmetrical oligoarthritis, it more commonly affects just one joint, with pain that worsens over a number of weeks with associated swelling, warmth and tenderness. Pseudogout is typically seen in older patients, and microscopy of the joint fluid would show positively birefringent rhomboid-shaped crystals.
10006755
e
Pseudogout
QuestionChoice
Reactive arthritis typically presents with the triad of arthritis, sterile urethritis, and conjunctivitis. This is a sterile inflammatory arthritis which typically occurs one-four weeks after a sexually-transmitted or gastrointestinal infection. When the inflammation also affects the eye and bladder or prostate, it can cause conjunctivitis and urethritis. This is typically a self-limiting condition and is usually managed conservatively with NSAIDs and rest.
10006751
a
Reactive arthritis
QuestionChoice
Septic arthritis would present as a systemically unwell patient, often with an acutely inflamed, hot, swollen joint. Movement of the joint will be limited. Aspiration and culture of the joint fluid will identify the causative agent - the most common of which is staphylococcus aureus.
10006754
d
Septic arthritis
QuestionChoice
Rheumatoid arthritis classically presents as a symmetrical polyarthritis, with warm and tender joints. It usually affects the joints of the hands, wrists, and feet. Other signs of rheumatoid arthritis include improvement of symptoms during movement. It is associated with females and smokers.
10006753
c
Rheumatoid arthritis
QuestionChoice
Psoriatic arthritis typically affects patients with pre-existing psoriasis, not acne. It is characterised by a personal history of psoriatic rash with arthritis. This may present as a symmetrical polyarthritis or an asymmetrical oligoarthritis. It is unlikely to cause the sterile urethritis and conjunctivitis seen in this patient.
10006752
b
Psoriatic arthritis
Concept
Chapter
2693
4539
Reactive arthritis
Topic
146
Rheumatology
13897
A 26-year-old man presents to the GP with pain on movement in his left knee and ankle. He has also noticed pain in his eyes at times, with some watery discharge and a stinging sensation when urinating. He was treated for chlamydia three weeks ago and has a past medical history of severe acne which has now resolved. On examination, the patient has bloodshot eyes, and pain on passive and active movement of the left knee and ankle joints. No discharge is seen from the penis. He is apyrexial and feels otherwise well.

Given the patient's presentation, what is the most likely diagnosis?
a