October 04, 2010

USMLE 2 Question 3

A strong association with Rheumatoid arthritis is a feature of

a) orbital pseudotumor
b) uveitis
c) episcleritis
d) scleritis
e) conjunctivitis

The correct answer is D

Scleritis,often associated with rheumatoid arthritis and other immune disorders, is a potentially destructive inflammation of the collagen in the deep episcleral vessels and the sclera. The eye is sometimes painful. Fortunately, scleritis is rare.

An experienced observer is required to make the diagnosis.

Scleritis coexists with a serious systemic disease in almost one-half of cases; frequently the underlying problem is a connective tissue disorder. Rheumatoid arthritis occurs almost one-third of the time, in patients suffering from scleritis.

Other connective tissue diseases seen with scleritis include: Systemic lupus erythematosus (SLE), Polyarteritis nodosa, Ankylosing spondylitis, Wegener's granulomatosis, Relapsing polychondritis, Sarcoidosis.

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