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MS (Tumor Young-Adult age, Upper limb, Lower limb), Arthritis, NSAID …

- - - - X-ray: Onion appearance
      - Histo: Anaplastic mall blue cell
  - - - X-ray: Codman triangle, Sunburst(Periostium reaction)
  - - - X-ray: Soap bubble
- - - - Monoarthritis, Pseudoparalysis, Hemorrhagic pustule by N.gonorrheae
      - P§: Sequestrum(necrotic bone), Involucrum(new bone)
      - WBC > 50k
        PMN > 75%
        Cluture post.
  - - - MTP of great toe
      - Needle-shaped(MSU), neg. Birefrigent crystal, WBCs>20k
      - Tx
        
        Acute pain
        
        Colchicine (ADR: Diarrhea, N/V), Drug interaction with Clarithromycin
        
        NSAID
        
        Corticosteroid
        
        Protection
        
        Allopurinol (HLA B* 5801 -> SJS)
        MOA: XO inhibitor
        
        Probenecid
        MOA: Uricosuric (block reabsorp Urate)
- - - - Eburnation, Subchondral bone cyst, Osteophyte(bone spur)
  - - - Olecranon
  - - - Pannus(granulation tissue), Bony Ankylosis, Hyperplasia(finger-like) synovium, Subcutaneous rheumatoid nodule
      - Ulnar deviate, Vasculitis, Lymphadenopathy
        Fatigue, Anorexia, Fever
      - Morning stiffness
      - Tx: DMARD
        
        MTX
        
        Leflunomide
        
        Anti-TNF: Etanercept, Infliximab
- - - - ADR
        
        Reye’s syndrome
- - - - sulfa derivative
- - - - Warfarin, Phenytoin, Sulfonylurea