Musculoskeletal · UKMLA & AKT
Rheumatoid arthritis
A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise rheumatoid arthritis — the full SA Note notes add investigations, management, complications and 10 practice questions.
Key high-yield points
- Symmetrical polyarthritis - MCP, PIP, and wrist joints most commonly; DIP joints typically spared
- Morning stiffness - lasting >1 hour, improves with activity (reflects active synovial inflammation)
- Systemic features - fatigue, malaise, low-grade fever
- Hand deformities (late disease) - ulnar deviation at MCPs, swan-neck (PIP hyperextension + DIP flexion), boutonnière (PIP flexion + DIP hyperextension), Z-deformity of thumb
DIP joint involvement favours OA or psoriatic arthritis - RA characteristically spares the DIPs. Psoriatic arthritis also causes dactylitis ('sausage digit') and nail changes, and can present as oligoarthritis before any rash appears.
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