Question

History of Arthritis involving 1^st MCP joint, other PIP & DIP joints, spares wrist and ankle. What could be the diagnosis ?

• A. Osteoarthritis
• B. Rheumatoid arthritis
• C. Psoriatic arthritis
• D. Gout

Answer 1

The Correct Option is A

The patient's condition, characterized by arthritis affecting the 1^st MCP joint as well as the PIP and DIP joints while sparing the wrist and ankle, is indicative of a specific form of arthritis. Let's analyze the options:

• Osteoarthritis: This type of arthritis commonly affects the DIP (Distal Interphalangeal) and PIP (Proximal Interphalangeal) joints, as well as the 1^st MCP (Metacarpophalangeal) joint. It is a degenerative joint disease, typically sparing the wrist and ankle. The clinical presentation matches the given symptoms.
• Rheumatoid arthritis: Typically involves the wrist and MCP joints first, and it symmetrically affects the joints, including the ankle.
• Psoriatic arthritis: Can involve any joints, often affecting the DIP joints, but usually presents with skin psoriasis and potentially affects the spine or the sacroiliac joints.
• Gout: Commonly affects the MTP joint (Metatarsophalangeal) of the big toe, but can also affect other joints including the ankle and foot.

Given the specific joint involvement and sparing of the wrist and ankle, the clinical findings are most consistent with Osteoarthritis.