Answer: Swelling of the knee capsule extending posteriorly to the popliteal fossa (hence the synonym popliteal cyst). Baker’s cyst is thought to develop as the knee is flexed, producing a significant rise in intra-articular pressure and an outpouching of the synovium posteriorly. The cruciate ligaments may act as a one-way valve, making it hard for [...]

Answer: The thoracic and lumbar spines are rarely if ever involved with RA. The cervical spine is commonly involved and deserves special mention. Cervical spine involvement usually is heralded by pain with motion and occipital headache. Significant laxity at the alantoaxial joint with subluxation makes patients prone to slowly progressive, spastic quadriparesis. If this laxity [...]

Answer: RA is a symmetric polyarthropathy that can involve almost any diarthrodial joint. The hands and wrists are involved in over 90% of patients. About one half of patients with RA develop x-ray evidence of hip involvement. Foot and ankle disease can have a major impact on function, although ankle involvement is rare in the [...]

Answer: Gelling describes the achiness and stiffness that occurs in patients with RA after a period of inactivity (such as getting up from the dinner table or rising from a seat after a movie). The stiffness that occurs on rising from bed in the morning is also a form of gelling. Reference:  Harris ED, Budd [...]

Answer: Hormonal status even beyond the female preponderance may play a role. Some studies have shown that nulliparity may increase the risk of disease. Pregnancy certainly influences the disease with upwards of 70% of pregnant women developing remission (with most suffering postpartum relapse). Another study suggested a role for breast-feeding in raising the risk of [...]

Answer: Both scleroderma and sclerodactyly refer to the fibrotic changes in skin occurring in systemic sclerosing conditions. The term scleroderma is used when these changes occur diffusely over the body: arms, torso, and face for example. Sclerodactyly is usually reserved to describe the skin tightening when it occurs in the fingers and hand (distal to [...]

Answer: Patches of erythematous scaly plaques on knuckles in patients with dermatomyositis. KEY POINTS: SIGNIFICANCE OF LAB VALUES IN RHEUMATOLOGIC DISEASE ANA titers are not associated with intensity of disease. Measurement of single-stranded DNA antibodies are of absolutely no clinical value. The HLA B27 association with arthritis is highest in AS and reactive arthritis but [...]