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Extra-articular and Other Conditions Associated with Joint Pain

Eyes
  • Iritis or uveitis - Spondyloarthropathies, Sarcoidosis,
Hyperthyroidism Fever ... • Rheumatic fever ... Neurologic system ... , Rheumatic fever ... • New murmur, fever
Approach to Joint Pain - Diagnostic Framework

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

1) Chronicity:
acute rheumatic fever ... Chronic = RA, SLE ... #rheumatology # ... approach #workup ... #differential #
Clinical Features of Systemic Lupus (SLE)
General: Fever (50%), Depression, Fatigue (75%), Weight loss (50%)
Eye: Sjögrens (15%)
Skin
Clinical Features ... Systemic Lupus (SLE ... ) General: Fever ... erythematosus #signs ... symptoms #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 ... • Rheumatic fever ... streptococci (rheumatic fever ... arthritis • SLE
Rheumatology Workup - Laboratories Studies in Rheumatic Diseases

• Septic arthritis - Gram stain and culture of
Rheumatology Workup ... of the affected joint ... ANA and RF (if clinical ... Arthritis #laboratory #workup ... diagnosis #testing #Rheumatology
Lyme Disease: Early and Late Clinical manifestations
Stage 1. Localized
 • EM appears 7-14 days at the
Early and Late Clinical ... arthralgia, headache, fever ... • Heralded by neurologic ... (knees), 1-2 joints ... Disease #diagnosis #signs
Systemic Lupus Erythematosus - Diagnosis
Manifestations:
 - Arthritis 69%
 - Malar rash 40%
 - Fever 36%
 -
Malar rash 40% - Fever ... involvement 3% SLE-Related ... Lupusreference #SLE ... autoantibodies #signs ... #rheumatology
Macrophage Activation Syndrome (MAS)
Classified among the secondary or acquired forms of haemophagocytic lymphohistiocytosis (sHLH)

What?
A subset of
disease • Periodic fever ... multiorgan failure • Fever ... - Nonremitting fever ... erythematosus [SLE ... Treatment: • Corticosteroids
SLICC SLE Diagnostic Criteria - Systemic Lupus Erythematosus
Clinical and Immunologic Criteria

CLINICAL CRITERIA
 - ACUTE CUTANEOUS LUPUS
SLICC SLE Diagnostic ... Erythematosus Clinical ... INVOLVING 2 OR MORE JOINTS ... SEROSITIS - RENAL - NEUROLOGIC ... #Diagnosis #Rheumatology