A 25-year-old man with inflammatory bowel disease has been experiencing lower back pain, stiffness, and buttock pain for the past six months. He notices that his pain improves after playing squash on Saturdays. He has tested positive for HLA-B27 and his blood tests, including C-reactive protein and erythrocyte sedimentation rate, are normal except for a mild hypochromic microcytic anemia. What is the most likely diagnosis?
A 32-year-old woman fell off her horse while horse-riding and is now experiencing severe foot pain. Her foot was trapped in the stirrup during the fall. An x-ray revealed displacement of her second and third metatarsal from the tarsus. What is the name of this injury?
A 40-year-old school teacher who enjoys running long distances comes to the clinic complaining of cramp-like pain in the forefoot that has been bothering them for the past week. During the examination, tenderness was noted over the dorsal distal portion of the second metatarsal. What is the probable diagnosis?
A 28-year-old man comes to the Clinic complaining of lower back pain and early morning stiffness that gradually improves as the day goes on. Upon examination, there is a decrease in forward flexion with a positive Schober’s test. A lumbar sacral X-ray confirms changes indicative of ankylosing spondylitis. What would be the primary treatment option to consider?
A 50-year-old woman visits the Rheumatology Clinic seeking modification of her DMARDs for the treatment of her rheumatoid arthritis. She is informed that she will require frequent liver checks and eye exams due to the potential side-effects of these medications. What is the most probable combination of treatment she will receive for her condition?
A 32-year-old Afro-Caribbean woman comes to the clinic with concerns about her appearance. She has noticed hair loss, a rash on her face, and mouth ulcers. Additionally, she has been experiencing joint pain and has been taking paracetamol and ibuprofen to manage it. This is her second visit to the clinic, and the registrar has already sent off some immunology tests. The results show a positive dsDNA antibody. What is the most probable diagnosis?
A 72-year-old man presented to his GP with complaints of fatigue, unintentional weight loss, and night sweats. He reported feeling generally down. Upon further questioning, he mentioned experiencing stiffness and pain in his shoulders and neck, particularly in the morning and lasting for about half an hour.
What would be the most appropriate investigation to perform in this case?
A 52-year-old man comes to the clinic complaining of a severely painful, swollen, and red left big toe. He states that it started yesterday and has become so excruciating that he cannot put on shoes. The patient has a medical history of type 2 diabetes and was diagnosed with a stomach ulcer last year. The diagnosis is a first episode of acute gout. What would be the most suitable initial treatment?
A 44-year-old gardener comes to her General Practitioner complaining of pain when kneeling on her right knee for the past month. She denies any fevers and is generally in good health. During the examination of her right knee, the doctor notices a slightly tender swelling in front of the patella that feels fluctuant. Although the knee is not red, it is warm to the touch, and the patient experiences some discomfort when flexing it. What are the probable results of joint aspiration?
A 27-year-old semi-professional rugby player presents with a red, hot, swollen left knee. There has been no history of trauma. He recently had a negative sexual health check and has not had any new partners since. Upon examination, the left knee is unable to fully extend and there is a large effusion. The clinical suspicion is septic arthritis. What is the most probable organism responsible for this condition?