247 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
Chronic Shoulder Pain - Differential Diagnosis Algorithm
4 tests for the AC joint:
1. Direct palpation
2. Cross-arm shoulder
Differential Diagnosis Algorithm ... 4 tests for the ... AC joint: 1. ... after cross-arm test ... Differential #Diagnosis #Algorithm
Joint Disorders - Differential Diagnosis Algorithm
Monoarthritis
 • Septic
 • Crystalline
     - Gout
Joint Disorders ... Differential Diagnosis Algorithm ... Gout - Uric Acid Crystals ... Pyrophosphate Dihydrate Crystals ... Differential #Diagnosis #Algorithm
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
Approach to Joint Pain

History:
Is the pain from:
	• Joint
	• Adjacent bursa
	• Tendon
	• Ligament
	• Bone
	• Muscle
	• Referred from
Approach to Joint ... present both at rest ... improves quickly with rest ... inflammatory arthritides Crystal ... ochronosis and crystal
Synovial Fluid Analysis:

Findings (COLOR	TRANSPARENCY	VISCOSITY	WBC COUNT (PER MM3)	PMN CELL COUNT (%)	GRAM STAIN	CULTURE	PCR TEST	CRYSTALS)

By Condition (Normal 
Noninflammatory 
Inflammatory:
STAIN CULTURE PCR TEST ... CRYSTALS) By ... Arthrocentesis #Joint
Rheumatoid arthritis (RA): X-ray features
 • Soft tissue swelling (best seen by comparing left & right
tissue swelling (best ... together) • Joint ... closer to the joints ... (Joint deformities ... Best visualized
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
These are oxalate crystals, which look like little envelopes (or tetrahedrons, depending upon your point of
These are oxalate crystals ... depending upon your point ... Oxalate crystals ... Microscopy #Oxalate #Crystals