Type Description Treatment 1 Boutonniere (most common) Synovectomy with extensor hood reconstruction; MCP fusion or arthroplasty 2 Boutonniere with CMC subluxation (uncommon; Type 1 + Type 3) Same as type 1 and type 3 3 Swan neck deformity (2nd most common) Splinting vs CMC arthroplasty; MCP fusion 4 Gamekeeper deformity…
Tag: Rheumatology
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Felty Syndrome : Mnemonics
Felty syndrome is a triad of: Mnemonic #1: SANTA Mnemonic #2: FAULTS
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Radiological Approach to Arthritis : Mnemonic
Mnemonic: ABCDES Alignment Bone – mineralization Bone – production Cartilage (Joint space) Calcification Distribution Erosions Soft tissues ABCDES of Arthritis of Wrist and Hand Features RA PsA OA EOA CPPD Gout Alignment (subluxation) Ulnar Multidirection Lateral Lateral None None Bone mineralization Osteopenia Normal Normal Normal Normal Normal Bone production None…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Rheumatoid Arthritis – ACR 2021 Guidelines: Summary
Among various methods of measuring disease activity in rheumatoid arthritis, we will be discussing Clinical Disease Activity Index (CDAI). CDAI = TJC(28) + SJC(28) + PGA(10) + EGA(10) Interpretation of CDAI: CDAI Score Range Disease Severity ≤ 2.8 Remission > 2.8 – 10.0 Low > 10.0 – 22.0 Moderate >…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Approach to Rheumatoid Factor Positive test
Rheumatoid factor (RF; also mistakenly called RA factor) is an auto-antibody (commonly IgM and rarely IgG or IgA) directed against the Fc portion of IgG. Increase in both IgM and IgA RFs is almost exclusively observed in patients with RA (Rheumatoid Arthritis). Clinical Significance of Rheumatoid Factor 1. A positive…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Rheumatoid hand
Ulnar drift or deviation of fingers Normal anatomical factors contributing to ulnar drift of fingers at MCP joint: Normal mechanical advantage of ulnar intrinsic muscles Asymmetry and ulnar slope of metacarpal heads of index and middle fingers Greater ulnar deviation permitted by radial collateral ligament when MCP joint is flexed…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Gout : Mnemonics
Urate Lowering Therapy (ULT) Mnemonic: 1, 2, 3, 4, 5, 6 Start Urate Lowering Therapy if: ≥1 subcutaneous tophi ≥2 flares per year ≥3 stage CKD with Serum uric acid (SUA) ≥ 9 mg/dl Other indications: Urate renal stone, Evidence of joint destruction in X-ray 4. ≥4 weeks to be…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Swan neck deformity vs Boutonniere deformity
Alterations in the relationships between the balanced extrinsic and intrinsic musculature of the hand due to trauma or secondary to the effects of systemic disease may cause the development of functional deformities such as a boutonnière or swan-neck deformity. Swan-neck deformity Boutonniere deformity Deformity PIPJ Hyperextension PIPJ Flexion DIPJ Flexion…