Thread by @KirtanPatolia

Differential diagnosis of RA-like arthritis based on the pattern of joint involvement is fascinating

Here is a 🧵 exploring this journey

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Various patterns of hand joint involvement

- PIP +DIP +1st CMC = OA
- MCP +PIP +Wrist = RA
- 2nd & 3rd MCP = Hemochromatosis
- Wrist +2nd MCP + 2nd PIP + all DIP= PsA
- Dactylitis/Sausage digits = PsA, Sickle cell anemia, Polyarticular gout, Sarcoidosis

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Infections causing RA-like pattern

- Parvovirus B19
- HTLV-1
- Rubella
- HBV, VZV, Mumps (Large joints more common)
- HIV
- Arboviruses: Chikungunya, Dengue
- Poncet's disease/ Tuberculous Rheumatism

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RA-like pattern in Connective tissue diseases

- Rhupus (RA+SLE)
- MCTD (SLE+SSc+PM/DM)
- Fibroblastic Rheumatism (RA+SSc like)
- Multi-centric reticulohistiocytosis
- Anti synthetase syndrome
- Anti MDA-5
- SLE
- IBD/Bowel arthritis dermatitis syndrome
-Relapsing polychondritis

RA-like pattern +/- large joints in Autoinflammatory diseases

- Palindromic Rheumatism
- SAPHO syndrome
- CRMO
- PAPA
- Schnitzler syndrome
- Deficiency of IL-1R antagonist
- Deficiency of IL-36R antagonist
- CANDLE syndrome
- Blau syndrome

RA-like pattern in Metabolic disorders

- Farber disease
- Alpha-1 antitrypsin deficiency
- Hemochromatosis
- Crystallopathies

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RA-like pattern in malignancies

- Angioimmunoblastic T-cell lymphoma
- HTLV and Adult T-cell leukemia
- Acute palmar fascitis with polyarthritis (Ovarian CA)
- Paraneoplastic arthritis

Miscellaneous entities mimicking arthritis

- RS3PE (Relapsing seronegative symmetric synovitis with pitting edema)
- PVNS (Pigmented villonodular synovitis)
- Thyroid acropachy
- HOA
- Vit A toxicity
- Voriconazole induced periostitis
- CRPS/Causalgia
- Charcot arthropathy

Any suggestions appreciated

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