162 results
Approach to Joint Pain - Diagnostic Framework

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

1) Chronicity:
Pain - Diagnostic ... mycobacterial), RA, crystal ... culture, look for crystals ... psoriatic arthritis Crystals ... #differential #diagnosis
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 ... after cross-arm test ... #Algorithm #MSK
Joint Disorders - Differential Diagnosis Algorithm
Monoarthritis
 • Septic
 • Crystalline
     - Gout
- Differential Diagnosis ... Algorithm Monoarthritis ... Gout - Uric Acid Crystals ... Pyrophosphate Dihydrate Crystals ... #Differential #Diagnosis
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 ... Septic arthritis #Diagnosis ... Arthrocentesis #Joint
Approach to Joint Pain

History:
Is the pain from:
	• Joint
	• Adjacent bursa
	• Tendon
	• Ligament
	• Bone
	• Muscle
	• Referred from
present both at rest ... improves quickly with rest ... inflammatory arthritides Crystal ... ochronosis and crystal ... #differential #diagnosis
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 ... nongonococcal ) #Diagnosis ... Arthrocentesis #Joint
Rheumatoid arthritis (RA): X-ray features
 • Soft tissue swelling (best seen by comparing left & right
tissue swelling (best ... together) • Joint ... (Joint deformities ... Best visualized ... #RA #HandXray #Diagnosis
CPPD vs Gout

== CPPD == 

Think About CPPD When:
 • Self-limited synovitis after surgery/trauma (> 65
swelling in weird joints ... culture used to diagnose ... deposition in joints ... stain and culture- Diagnose ... #rheumatology #Diagnosis
Rheumatology Workup - Laboratories Studies in Rheumatic Diseases

• Septic arthritis - Gram stain and culture of
intracellular urate crystals ... pyrophosphate dihydrate crystals ... of the affected joint ... (to support a diagnosis ... laboratory #workup #diagnosis
Hyperthyroidism (low TSH, High T4/T3) - Diagnostic Algorithm

Radioactive iodine scan – get if concern for nodular
High T4/T3) - Diagnostic ... Algorithm Radioactive ... Key teaching point ... Check pregnancy test ... #Algorithm #Workup