57-year-old woman with rheumatoid arthritis has been attending the Rheumatology Clinic for several years. You are reviewing her case notes in order to summarise her case for referral to a colleague.



While the presentation and progression of rheumatoid arthritis is variable, what is the most common form or course of t his condition? 

A 27-year-old man complains of low back pain for some years. He says he had an episode of severe diarrhoea 3 weeks earlier, and that he has experienced waxing and waning stomach problems that have gone on for a couple of years. An X-ray of the lumbosacral spine shows erosion of t he lower joint margins of the vertebrae.



What is the probable diagnosis? 

A 74-year-old man has an acutely painful, red and swollen knee. He is suffering from congestive cardiac failure, chronic renal impairment and is currently on digoxin and furosemide. A most recent creatinine was measured at 135 micromol/1. CRP is slightly elevated and white cell count is normal.



What treatment would be most appropriate for his joint pain? 

You review a 21-year-old man who suffered from Still's disease as a child. Which one of the following are common features of Still's disease? 

A 44-year-old woman complains of tiredness and lower limb joint pains.



Which one of the following joint findings is most suggestive of an inflammatory rather than an osteoarthritic cause of joint pain?