Systemic lupus erythematosus
Select the most likely cause of arthropathy from the list
above to match each of the scenarios given below:
1) A 24-year-old male presents with a gradual onset of
backache and morning stiffness that is improved by exercise. On examination of
his spine there is decreased spinal mobility and when he stands with his back
to a wall, the occiput does not touch the wall.
2) A 50-year-old female presents with pain and stiffness
of her hands and wrists. The stiffness is worse in the morning and gets better
as the day progresses. On examination she has swelling of her
metacarpophalangeal joints and there is ulnar deviation at the
metacarpophalangeal joints. Joint movement is impaired.
3) A 45-year-old man presents with pain and deformity of
the joints of his hands. On examination the nails show pitting and the distal
interphalangeal joints are painful and deformed on both sides.
4) A 70-year-old male presents with severe pain in the
right first metatarsophalangeal joint. The pain woke him up from his sleep. On
examination the joint is swollen red and painful and tender.
5) A 75-year-old man who has had long-standing problems
with his joints presents with pain and swelling of his right knee. On
examination he is febrile, the skin overlying the knee looks red, it is hot
and there is evidence of fluid within the joint.