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rheumatology management differential joint pathophysiology ac acromioclavicular approach assessment checklist chesttube classification clinical comparison criticalcare degenerative drains extraarticular gout inflammatory
Approach to Joint Pain History: Is the pain from: • Joint • Adjacent bursa • Tendon • Ligament • Bone • Muscle • Referred from
Adjacent bursa • Tendon ... present both at rest ... e.g., meniscal tears ... #Joint #Pain #MSK ... #differential #diagnosis
Acromioclavicular (AC) Joint Septic Arthritis on POCUS IVDU with severe left shoulder pain. Can fully range
Tender on top of ... Diagnosis? ... Culture MRSA. ... #clinical #ultrasound ... #MSK
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 Rheumatoid arthritis (RA): Extra-articular manifestations Skin: • Inflammation of skin (esp. over areas of stress) forms
Rheumatoid arthritis ... infiltration damages tear ... pain, pleural effusion ... RA inflammation tends ... signs #symptoms #diagnosis
Distinguishing between Inflammatory and Degenerative joint disease Inflammatory Joint Disease • Swelling stimulates joint nociceptors -> Pain
in Rheumatoid arthritis ... weight-bearing joints tend ... to bear the brunt ... Comparison #Versus #MSK ... JointDisease #JointPain #Diagnosis
Vasculitis and Vasculitides - Differential Diagnosis Framework When to Consider Vasculitis: • Purpura, ischemic skin lesions •
- Differential Diagnosis ... , obstructive pulmonary ... well as inner ear ... diminished, or tender ... retinopathy Lab Tests
Assessment of Chest Tube Drains Stepwise assessment of Chest Tube Function TUBE POSITIONING • Look at the CXR:
can be used to clear ... pneumothorax • 24-28 Fr tension ... drainage of an effusion ... being on water sear ... ChestTube #Drains #Diagnosis
Gout - Diagnosis and Management Summary 3 Conditions for Gout to Manifest: 1. Hyperuricemia 2. Monosodium urate deposition in
frequent attacks • Arthritis ... elbows, Achilles tendon ... not possible • Ultrasound ... Dual-energy CT → MSU ... 2 attacks in a year
Sjogren's Syndrome Overview Epidemiology: • F > M: 9:1 • 5-6th Decades (can be any age) Autoimmune exocrinopathy multisystemic disease
thickening or effusion ... , INC risk PE, Pulmonary ... phenomenon (16%) MSK ... Arthralgia and Arthritis ... Symptomatic: artificial tears
Severe Influenza Checklist Diagnostic tests - Blood cultures x2 - Sputum gram stain & culture
tests - Blood ... liver function tests ... - Ultrasound ... needed to exclude effusion ... lab-confirmed influenza, pulmonary
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