01-05-2007, 10:42 AM
30-year-old woman presents with
low back pain, and a swollen and
painful right ankle and left knee
for 1 week. She also reports
temperatures to 39.0 C (102.2 F).
She recalls that a few weeks ago,
she had diarrhea, abdominal
cramps, and fever, which lasted
for a few days. She does not have
previous history of joint diseases
or sexually transmitted diseases.
Examination reveals skin pustules
and crusted vesicles on her palms
and soles, red conjunctivae, and
arthritis of the left knee and
right ankle. There is no
hepatomegaly, splenomegaly, or
lymphadenopathy. Laboratory
analysis show an elevated
erythrocyte sedimentation rate
(ESR), but no anemia. Which of the
following is the most likely
diagnosis?
A.
Psoriatic arthritis
B.
Reiter syndrome
C.
Rheumatic fever
D.
Rheumatoid arthritis
E.
Syphilitic infection
is it B?
low back pain, and a swollen and
painful right ankle and left knee
for 1 week. She also reports
temperatures to 39.0 C (102.2 F).
She recalls that a few weeks ago,
she had diarrhea, abdominal
cramps, and fever, which lasted
for a few days. She does not have
previous history of joint diseases
or sexually transmitted diseases.
Examination reveals skin pustules
and crusted vesicles on her palms
and soles, red conjunctivae, and
arthritis of the left knee and
right ankle. There is no
hepatomegaly, splenomegaly, or
lymphadenopathy. Laboratory
analysis show an elevated
erythrocyte sedimentation rate
(ESR), but no anemia. Which of the
following is the most likely
diagnosis?
A.
Psoriatic arthritis
B.
Reiter syndrome
C.
Rheumatic fever
D.
Rheumatoid arthritis
E.
Syphilitic infection
is it B?