MSK Purple Pages Exam Questions With
Complete Answers
Joint Pain - Rheum Arthritis - ANSWER -process: chronic inflammation of synovial
membranes
-common locations: hands (PIP, MCP), feet (MTP), wrists, knees, elbows, ankles
-pattern of spread: symmetrically additive
-onset: usually insidious
-progress/duration: often chronic, with remission and exacerbations
-swelling: synovial tissues in joints, SQ nodules
-red/warm/tender: tender, often warm
-stiffness: prominent
-limitation: often develops
-sx: weakness, fatigue, wt loss, low-grade fever
Joint Pain - Osteoarthritis - ANSWER -process: degenerative and progressive loss of
joint cartilage
-locations: knees, hips, hands, spine, wrists
-spread: additive, may involve only one joint
-onset: usually insidious
-progress: slowly progressive w/temp exacerbations after period of overuse
-swelling: small joint effusions, bony enlargement
-red/warm/tender: possible tender
-stiffness: frequent but brief (AM, inactivity)
-limitations: often develops
-sx: usually absent
Joint Pain - Acute Gout - ANSWER -process: inflammatory rxn to microcrystals of
monosodium urate
, -location: base of big toe, instep of dorsa of feet, ankles, knees, elbows
-spread: early attacks usually confined to 1 joint
-onset: sudden, often at night, after injury, surgery, fasting, or excessive food or EtOH
-progress: last days to weeks, may get more frequent and severe
-swelling: present
-red/warm/tender: exquisitely tender, hot, red
-stiffness: none
-limited: motion limited by pain
-sx: fever may be present
Joint Pain - Chronic Tophaceous Gout - ANSWER -process: multiple accumulations of
sodium urate
-locations: feet, ankles, wrists, fingers, elbows
-pattern: additive
-onset: gradual development of chronicity
-progress: chronic sx w/acute exacerbations
-swelling: present as tophi in joints, bursae, SQ
-red/tender/warm: tenderness. warmth, red may be present during exacerbations
-stiffness and limitation present
-sx: fever, may develop renal failure or stones
Joint Pain - Polymyalgia Rheumatica - ANSWER -location: muscles of hip, shoulder
girdle, neck - symmetric
-onset: insidious or abrupt, even overnight
-progress: chronic but ultimately self-limiting
-swelling: may be present over dorsum of hands, wrists, feet
-red/warm/tender: often tender
-stiffness: prominent, esp in morning
-limitation: pain restricts movements, esp in shoulders
-sx: malaise, depression, anorexia, wt loss, fever
Complete Answers
Joint Pain - Rheum Arthritis - ANSWER -process: chronic inflammation of synovial
membranes
-common locations: hands (PIP, MCP), feet (MTP), wrists, knees, elbows, ankles
-pattern of spread: symmetrically additive
-onset: usually insidious
-progress/duration: often chronic, with remission and exacerbations
-swelling: synovial tissues in joints, SQ nodules
-red/warm/tender: tender, often warm
-stiffness: prominent
-limitation: often develops
-sx: weakness, fatigue, wt loss, low-grade fever
Joint Pain - Osteoarthritis - ANSWER -process: degenerative and progressive loss of
joint cartilage
-locations: knees, hips, hands, spine, wrists
-spread: additive, may involve only one joint
-onset: usually insidious
-progress: slowly progressive w/temp exacerbations after period of overuse
-swelling: small joint effusions, bony enlargement
-red/warm/tender: possible tender
-stiffness: frequent but brief (AM, inactivity)
-limitations: often develops
-sx: usually absent
Joint Pain - Acute Gout - ANSWER -process: inflammatory rxn to microcrystals of
monosodium urate
, -location: base of big toe, instep of dorsa of feet, ankles, knees, elbows
-spread: early attacks usually confined to 1 joint
-onset: sudden, often at night, after injury, surgery, fasting, or excessive food or EtOH
-progress: last days to weeks, may get more frequent and severe
-swelling: present
-red/warm/tender: exquisitely tender, hot, red
-stiffness: none
-limited: motion limited by pain
-sx: fever may be present
Joint Pain - Chronic Tophaceous Gout - ANSWER -process: multiple accumulations of
sodium urate
-locations: feet, ankles, wrists, fingers, elbows
-pattern: additive
-onset: gradual development of chronicity
-progress: chronic sx w/acute exacerbations
-swelling: present as tophi in joints, bursae, SQ
-red/tender/warm: tenderness. warmth, red may be present during exacerbations
-stiffness and limitation present
-sx: fever, may develop renal failure or stones
Joint Pain - Polymyalgia Rheumatica - ANSWER -location: muscles of hip, shoulder
girdle, neck - symmetric
-onset: insidious or abrupt, even overnight
-progress: chronic but ultimately self-limiting
-swelling: may be present over dorsum of hands, wrists, feet
-red/warm/tender: often tender
-stiffness: prominent, esp in morning
-limitation: pain restricts movements, esp in shoulders
-sx: malaise, depression, anorexia, wt loss, fever
