Max Konig Profile picture
Nov 11, 2019 13 tweets 5 min read Read on X
Path in GPA vs RP
Relapsing polychondritis criteria #ACR19
Absence of typical manifestation of RP such as saddle nose deformity, ear inflammation, and subglottic stenosis does not exclude, but delays Dx #ACR19
ANCA positivity in up to 25% of patients with RP. Anti-collagen II antibodies are not sensitive and may only be positive in active disease.
How to workup relapsing polychondritis:
Differential of auricular inflammation @philseo #ACR19
Differential diagnosis of saddle nose deformity
@philseo How to treat relapsing polychondritis
Pear: In #GPA, nasal septum perforation precedes nasal bridge collapse, while nasal bridge can collapse in isolation and without warning in #relapsingpolychondritis #ACR19
*Pearl

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More from @MaxKonigMD

Nov 3, 2019
1/ A 46-year-old man with a history of #malaria presented to the @JohnsHopkinsDOM on 8/12/1923 with

-- 3 years of generalized arthralgia
-- intermittent joint swelling

-- 40 lbs weight loss

@CPSolvers @DxRxEdu #medtwitter #MedEd
2/ Exam

-- synovitis of the 2nd and 3rd MCPs

-- diffuse joint tenderness

-- lymphadenopathy

-- pyorrhea alveolaris* of the few remaining teeth.


What do you want to do next? What's your #DDX?

Remember: Sir William Osler died in 1919, so it's all you...
So far, we have #tuberculosis on the differential. “Consumption” or “#phthisis”, wasting away, as #Tb was often referred to, certainly could explain this patients weight loss and adenopathy.

But does it explain the rest?
Read 16 tweets

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