Paper IV — Bone and joint

Cross-Topic Rapid Revision Grid

Condition One-line hallmark Key investigation First-line treatment Osteoporosis Low mass + poor DXA T-score ≤ −2.5, FRAX Calcium/vitamin D + microarchitecture, fragility bisphosphonate; anabolic-first if fracture very high risk Paget’s disease Focal, disorganised remodelling; X-ray + radionuclide bone scan Single 5 mg IV zoledronate high ALP with normal calcium Osteoarthritis Activity pain, stiffness in minutes, Clinical ± X-ray Exercise + weight loss + topical osteophytes NSAID Giant cell arteritis Headache, jaw claudication, Ultrasound halo sign / temporal Immediate high-dose steroid ± visual loss, ESR >75 artery biopsy tocilizumab or upadacitinib Dermatomyositis Heliotrope rash + Gottron’s + Myositis antibody panel, MRI, Prednisolone + early steroid-proximal weakness biopsy sparing agent; IVIG if refractory DISH Flowing ossification, dysphagia, Lateral thoracic X-ray (Resnick), Symptomatic; metabolic control; metabolic syndrome CT surgery for dysphagia