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diagnosis rheumatology erythematosus joint sle arthritis cardiology msk systemic algorithm approach causes clues comparison conditions dermatology extrarticular infectiousdiseases management monoarthritis
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
Myositis and Myopathies Polymyositis • Progressive, symmetric muscle weakness • Elevated CK, +Anti-Jo, +Anti-Mi2 Dermatomyositis
Rheumatica • Pain ... proximal joints, Fever ... Detectable HIV viral ... Diffuse muscle pain ... Myopathies #myopathy #differential
Extra-articular and Other Conditions Associated with Joint Pain Eyes • Iritis or uveitis - Spondyloarthropathies, Sarcoidosis,
Associated with Joint Pain ... Subacute bacterial endocarditis ... - Bacterial endocarditis ... #differential # ... diagnosis #rheumatology
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 ... and fingers, or pain ... the face (many differential ... ; sometimes « viral ... 9) Unexplained fever
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
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 ... Arthritis: • Joint pain ... • Libman-Sacks endocarditis ... Cytopenias • Cardiac valve
Approach to Joint Pain - Arthritis Differential Diagnosis Framework Inflammatory Versus Noninflammatory Pain • Is it inflammatory
- Arthritis Differential ... • Rheumatic fever ... or more joints Viral ... • Bacterial endocarditis ... #Differential #
Endocarditis - Overview and Differential Diagnosis Framework Who? Infectious: • Pre-existing valvular disease • Prosthetic valve • Congenital heart disease • IV
and Differential ... involves aortic and mitral ... night sweats, fever ... Persistent bacteremia/fevers ... #Endocarditis #Differential
Approach to Joint Pain - Diagnostic Framework 1) Chronicity 2) Inflammatory vs Non-Inflammatory 3) Number of Joints Involved 1) Chronicity:
Approach to Joint Pain ... acute rheumatic fever ... spondyloarthropathies, lupus ... #rheumatology # ... approach #workup #differential
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