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Disseminated Gonococcal Infection - Diagnosis and Management Summary

Bacteremic spread of the Gram-negative diplococci Neisseria gonorrhoeae. History
Disseminated Gonococcal ... the preferred test ... an accessible joint ... the workup • Test ... #Disseminated #Gonococcal
Approach to Joint Pain - Diagnostic Framework

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

1) Chronicity:
Approach to Joint ... (bacterial, gonococcal ... neuropathy so trauma and ... that patient had ... remember yellow and
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 ... Infectious: gonococcal ... Arthrocentesis #Joint
Gonococcal Ophthalmia Neonatorum (GON) - Figure 1

A 4-day-old girl was brought to the emergency department (ED)
Gonococcal Ophthalmia ... A 4-day-old girl ... 2 days earlier and ... and yellow-green ... Pediatrics #Gonorrhea #Gonococcal
Distinguishing between Inflammatory and Degenerative joint disease
Inflammatory Joint Disease
 • Swelling stimulates joint nociceptors -> Pain
between Inflammatory and ... nociceptors -> Pain with rest ... Blood carries heat and ... motion (relieved by rest ... affects the knee hip and
Illustrations showing elements of a shoulder assessment. Also included on a shoulder assessment would be determination
acromioclavicular joint ... (using Speed's test ... (In Speed's test ... pushes down on the hand ... is a positive test
Bunnel-Littler PIP Joint Test on Physical Exam
For intrinsic vs joint capsule cause of restriction or tightness
Bunnel-Littler PIP Joint ... Test on Physical ... unaffected side and ... to do with both hands ... BunnelLittler #Test
Ice-pack Test for Myasthenia Gravis - Likelihood Ratio (LR) +24 / -0.16
Ice pack's can be used
Ice-pack Test for ... depolarization and ... improving ptosis and ... VA Joint Chiefs ... BostonChiefs #Icepack #Test
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 ... and with motion ... during motion and ... improves quickly with rest
Rheumatology Workup - Laboratories Studies in Rheumatic Diseases

• Septic arthritis - Gram stain and culture of
spondylitis - Sacroiliac joint ... of the affected joint ... antibody (ANA) test ... ; if positive, test ... • Sacroiliac joint