19 results
Approach to Joint Pain - Diagnostic Framework

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

1) Chronicity:
acute rheumatic fever ... ), RA, crystal disease ... Inflammatory, crystalline disease ... #rheumatology # ... approach #workup #differential
STEMI Equivalents on ECG
 • Conventional STEMI - Elevation of ST segment at (or 40-60 ms
ms after) the J point ... • De Winter syndrome ... V2 • Wellens sign ... pain • Wellens sign ... EKG #diagnosis #differential
Fever Patterns - Differential Diagnosis Framework

Continuous Fever:
Temp > 38°C with only 1 degree fluctuation in 24
Differential Diagnosis ... • Rickettsial diseases ... falls (like a wave ... Brucellosis Faget's Sign ... #Patterns #Differential
Extra-articular and Other Conditions Associated with Joint Pain

Eyes
  • Iritis or uveitis - Spondyloarthropathies, Sarcoidosis,
Associated with Joint ... Heberden's nodes (DIP joints ... Bouchard's nodes (PIP joints ... #pain #differential ... #diagnosis #rheumatology
Skin Conditions Associated with Joint Pain

Rash
	• Human parvovirus B19 infection

Malar rash
	• SLE
	• Human parvovirus B19 infection
	•
Associated with Joint ... • Rheumatic fever ... #dermatology #joint ... #skin #rashes #differential ... #diagnosis #rheumatology
Approach to Joint Pain - Arthritis Differential Diagnosis Framework

Inflammatory Versus Noninflammatory Pain
 • Is it inflammatory
Pain - Arthritis Differential ... noninflammatory Signs ... - Autoimmune Rheumatologic ... • Rheumatic fever ... #pain #Differential
Approach to ECGs - Ischemia
MI = Biomarkers + ECG or echo/angiogram findings
Pathologic Q - 1/3 height
infarct STEMI - J point ... Equivalents / Don't Miss Signs ... bigger than QRS - deWinter ... triple vessel disease ... Interpretation #differential
Clinical Features of Systemic Lupus (SLE)
General: Fever (50%), Depression, Fatigue (75%), Weight loss (50%)
Eye: Sjögrens (15%)
Skin
(SLE) General: Fever ... phenomenon (20%) Joints ... pain (20%) Renal disease ... erythematosus #signs ... symptoms #diagnosis #rheumatology
Systemic Lupus Erythematosus - Diagnosis
Manifestations:
 - Arthritis 69%
 - Malar rash 40%
 - Fever 36%
 -
Malar rash 40% - Fever ... (aPL) 30-45% Differential ... sclerosis, Still's disease ... autoantibodies #signs ... #rheumatology
Bilateral B-Lines in case of Pneumonia on Lung POCUS

Young healthy pt with fever/dyspnea. POCUS lung exam
healthy pt with fever ... immunosuppression, travel ... Differential Bilat ... interstitial lung disease ... partially seen shred sign