American Board of Internal Medicine (ABIM) Certification Practice Exam

Secondary osteoarthritis in hemochromatosis typically involves which joints?

1. Knee and ankle joints

2. Metacarpophalangeal and wrist joints

3. Hip and shoulder joints

4. Elbow and spine joints

The correct answer is: Metacarpophalangeal and wrist joints

In the context of secondary osteoarthritis associated with hemochromatosis, the most commonly affected joints include the metacarpophalangeal (MCP) joints and the wrist joints. Hemochromatosis is a condition characterized by excessive iron accumulation in the body, which can lead to joint damage and consequent osteoarthritis. The MCP joints are particularly susceptible due to the unique wear and tear associated with both the disease and the inherent use of the hands, especially in individuals who may have a history of manual labor or repetitive use. While other joints such as the knees, ankles, hips, shoulders, elbows, and spine can also be involved in osteoarthritis, the specific selection of the MCP and wrist joints is linked to the pattern of damage seen in patients with hemochromatosis. This demographic commonly presents with swelling, stiffness, and pain in the hands, leading to the development of secondary osteoarthritis in these areas. The focus on the hands, especially the MCP joints, can help differentiate the causes of osteoarthritis in hemochromatosis from other forms of arthritis and contributes to the overall management and treatment approaches for patients suffering from this condition.