26/01/2026
6 TYPES OF ARTHRITIS...
1️⃣ Osteoarthritis
💡 Cartilage wears down. Mechanical, not inflammatory. Weight-bearing joints.
Classic presentation:
They’ll give you elderly/obese patient, knee or hip pain WORSE with activity, BETTER with rest.
Morning stiffness 1 hour. Improves with use.
⚠️ Spares DIP - that’s OA. Swan neck, boutonniere deformities.
🏥 Tx: Methotrexate first-line. TNF inhibitors.
3️⃣ Gout
🔬 Crystal—urate
💡 Needle-shaped, NEGATIVELY birefringent (yellow parallel).
Classic presentation:
They’ll give you sudden severe FIRST MTP pain (podagra) - red, hot, exquisitely tender.
After alcohol, meat, thiazides.
⚠️ Don’t start allopurinol during acute attack.
🏥 Tx:
Acute—NSAIDs, colchicine.
Chronic—allopurinol.
4️⃣ Pseudogout
🔬 Crystal - calcium pyrophosphate
💡 Rhomboid-shaped, POSITIVELY birefringent (blue parallel). Opposite of gout.
Classic presentation:
They’ll give you elderly patient, acute KNEE pain.
X-ray shows chondrocalcinosis.
⚠️ Associated: hemochromatosis, hyperparathyroidism.
🏥 Tx: NSAIDs, colchicine, steroids.
5️⃣ Septic Arthritis
💡 Bacteria destroy cartilage in hours. Staph #1. Gonococcal in young sexually active.
Classic presentation:
They’ll give you hot, swollen joint with fever.
Can’t move it.
WBC >50,000, >75% PMNs.
⚠️ TAP THE JOINT. Don’t wait.
Gonococcal = migratory arthritis + tenosynovitis + skin lesions.
🏥 Tx: IV antibiotics immediately. Drainage.
6️⃣ Reactive Arthritis
💡 Sterile inflammation after GI (Salmonella, Shigella) or GU (Chlamydia) infection. HLA-B27.
Classic presentation:
They’ll give you young man, asymmetric arthritis 1–4 weeks after diarrhea or urethritis.
⚠️ Enthesitis, dactylitis (sausage digits).
🏥 Tx: NSAIDs. Treat infection if present.
