<prompt> Erosion of bones seen in all except:SLEPsoriasisRAGout  <response>: Ans- A SLE Ref: Harrisons Principles of Internal Medicine, 18th edition, pg 2728 Explanation: SLE causes non erosive polyarthritis of the hands, wrist knees. Can cause avascular necrosis of joints increased by steroid use. Psoriasis, RA gout cause erosive arthritis. Psoriatic Arthritis PsA: DIP involved, nail changes pitting, ridging, onycholysis, yellow discoloration, hyperkeratosis dactylitis Asymmetrical oligoarthritis Symmetrical polyarthritis Arthritis mutilans with destruction and telescoping of digits CASPAR criteria used to diagnose PsA Treatment; Anti-TNF-a- infliximab, etanercept, adalimumab, golimumab Anti T cell- Alefacept Newer agent- Ustekinumab Methotrexate, sulfasalazine, letlunomide Rheumatoid Arthritis RA: MCP, PIP, MTP involved Juxta-articular osteopenia- earliest radiological finding ACR EULAR revised criteria used to diagnose RA Treatment: Anti TNF- a- Infliximab. Etanercept, adalimumab. golimumab, certolizumab Abatacept, unakinra. rituximab, tocilizumab Gouty arthritis: Acute, monoarthritis, 1st MTP involved Precipitated by diet, trauma, surgery, alcohol.stress Joint aspirate for needle shaped MSU crystals, birefringent with negative elongation. TC 2-60 thousand S.uric acid can be low normal during attack Acute attack-NSAIDS. Colchicine, steroids, anakinra Hypouricemic drugs- AUopurinoi. febuxostat. Rasburicase, pegloticase 