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Surgery General 1c793b8e

A patient with severe ahritis suddenly becomes unable to move his arms or legs. He is admitted to the neurology floor of the hospital, but his quadriplegia does not improve with time. If the quadriplegia is due to his ahritis, which of the following types of ahritis does this patient most likely have?

A
Ankylosing spondylitis
B
Gouty ahritis
C
Osteoahritis
D
Rheumatoid ahritis
High-Yield Explanation
Involvement of the cervical spine occurs in almost 80% of patients with rheumatoid ahritis, and involves the atlantoaxial joint in up to 25% of patients hospitalized for rheumatoid ahritis. Founately, large degrees of subluxation of the joint are rare, but if present, can be associated with quadriplegia, and even sudden death if the odontoid peg separates from the arch of the atlas and compresses the spinal cord. Serious complications of ankylosing spondylitis include atrioventricular block, bladder and bowel dysfunction, uveitis, pulmonary fibrosis, psoriasis, and inflammatory bowel disease. Serious complications of gout include renal impairment. Serious complications of osteoahritis are uncommon, but the local manifestations can be crippling. Ref: Bednar M.S., Light T.R. (2006). Chapter 10. Hand Surgery. In H.B. Skinner (Ed), CURRENT Diagnosis & Treatment in Ohopedics, 4e.

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