691 results
Approach to Joint Pain - Diagnostic Framework

1) Chronicity
2) Inflammatory vs Non-Inflammatory
3) Number of Joints Involved

1) Chronicity:
Approach to Joint ... 3) Number of Joints ... mycobacterial), RA, crystal ... culture, look for crystals ... psoriatic arthritis Crystals
Chondrocalcinosis: Calcium Pyrophosphate Dihydrate (CPPD) Deposition Disease

 - Acute CPPD precipitation into the joint space ->
precipitation into the joint ... Inflammatory response to crystals ... Repeated subacute crystal ... precipitation into joint ... selected MCP/PIP joints
Gout: Pathogenesis and Clinical Findings
 - Conditions of rapid cell turnover: hemolysis, psoriasis, lymphoproliferative disorders
 -
easily leaks into joints ... in a peripheral joint ... Neutrophils enter joint ... phagocytose the crystal ... Needle-shaped uric acid crystals
Arthrocentesis - Joint Fluid Analysis

Effusion Characteristics (Color, Clarity, WCC, PMN, Crystals, Bacteria) by Disease Process: 
OA,
Arthrocentesis - Joint ... Clarity, WCC, PMN, Crystals ... positively birefringent crystals ... negatively birefringent crystals ... Arthrocentesis #Joint
CPPD vs Gout

== CPPD == 

Think About CPPD When:
 • Self-limited synovitis after surgery/trauma (> 65
swelling in weird joints ... Acute CPP Crystal ... MCP, or shoulder joints ... deposition in joints ... attacks • Other joints
Gouty arthritis of the shoulder joint

50 yo male presented with shoulder pain.

Note double contour sign at
of the shoulder joint ... deposition of crystal ... POCUS #Ultrasound #Crystals
Joint Disorders - Differential Diagnosis Algorithm
Monoarthritis
 • Septic
 • Crystalline
     - Gout
Joint Disorders ... Gout - Uric Acid Crystals ... Pyrophosphate Dihydrate Crystals ... Lumbar Spine and SI Joints ... @AmyChung #Joint
Pseudogout: pathogenesis and clinical findings
 - Idiopathic (vast majority of cases) -> Mechanism unknown
 - Familial
dihydrate (CPPD) crystals ... from joints is ... x-ray - CPPD Crystals ... birefringent (crystals ... warm, swollen joint
Arthritis of the Hand - Arthritis Patterns

Osteoarthritis:
• Osteoarthritis of the hand usually involves the DIP and
the DIP and PIP joints ... the PIP and MCP joints ... but not the DIP joints ... 5% of times Joint ... Psoriatic arthritis, crystal-induced
Approach to Joint Pain

History:
Is the pain from:
	• Joint
	• Adjacent bursa
	• Tendon
	• Ligament
	• Bone
	• Muscle
	• Referred from
Approach to Joint ... pain from: • Joint ... categories of joint ... inflammatory arthritides Crystal ... ochronosis and crystal