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diagnosis rheumatology cardiology erythematosus sle arthritis causes msk systemic algorithm approach clues comparison conditions dermatology extrarticular infectiousdiseases management monoarthritis monoarticular
Primary and Secondary Causes of Mitral Regurgitation Primary (organic) chronic mitral regurgitation: • Leaflet: Rheumatic fever, Infective
Leaflet: Rheumatic fever ... • Prosthetic valve ... annulus valve: ... cardiomyopathy - VA Joint ... Regurgitation #differential
Myositis and Myopathies Polymyositis • Progressive, symmetric muscle weakness • Elevated CK, +Anti-Jo, +Anti-Mi2 Dermatomyositis
Rheumatica • Pain ... , Fever, No muscle ... Detectable HIV viral ... Diffuse muscle pain ... Myopathies #myopathy #differential
Clinical Features of Systemic Lupus (SLE) General: Fever (50%), Depression, Fatigue (75%), Weight loss (50%) Eye: Sjögrens (15%) Skin
Features of Systemic Lupus ... (SLE) General: Fever ... Pericarditis, Endocarditis ... , Aortic valve lesions ... Abdominal pain
Extra-articular and Other Conditions Associated with Joint Pain Eyes • Iritis or uveitis - Spondyloarthropathies, Sarcoidosis,
Associated with Joint ... Pain Eyes ... Subacute bacterial endocarditis ... - Bacterial endocarditis ... #pain #differential
Approach to Joint Pain - Diagnostic Framework 1) Chronicity 2) Inflammatory vs Non-Inflammatory 3) Number of Joints Involved 1) Chronicity:
Pain - Diagnostic ... acute rheumatic fever ... spondyloarthropathies, lupus ... #Joint #Pain #MSK ... approach #workup #differential
Approach to Joint Pain - Arthritis Differential Diagnosis Framework Inflammatory Versus Noninflammatory Pain • Is it inflammatory
Differential Diagnosis ... • Rheumatic fever ... Viral Infections ... • Bacterial endocarditis ... #pain #Differential
Endocarditis Summary Who? Infectious: • Pre-existing valvular disease • Prosthetic valve • Congenital heart disease • IV substance use • IV catheter • Recent
Involves aortic and mitral ... night sweats, fever ... Marantic (NTBE) Differential ... Paradoxical emboli via ASD ... Persistent bacteremia/fevers
Top 10 situations when to think about lupus 1) Inflammatory joint pain (especially in the wrists and
) Inflammatory joint ... pain (especially ... the face (many differential ... ; sometimes « viral ... 9) Unexplained fever
SLE (Systemic Lupus Erythematosus) Suspect: Clinical evidence of (fatigue, rash, photosensitivity, inflammatory arthritis, weight loss, and fever) and
weight loss, and fever ... permanent alopecia Differential ... pain • Swan neck ... • Libman-Sacks endocarditis ... Cytopenias • Cardiac valve
Causes of Petechial Rash - Differential Diagnosis Algorithm Pinpoint areas (less than 2 mm) of hemorrhage, which
Petechial Rash - Differential ... Red Flags: • Fever ... lesions • Severe pain ... Schonlein Purpura - Endocarditis ... Autoimmune Vasculitis (lupus
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