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Extra-articular and Other Conditions Associated with Joint Pain

Eyes
  • Iritis or uveitis - Spondyloarthropathies, Sarcoidosis,
Hyperthyroidism Fever ... • Rheumatic fever ... - SLE Neurologic ... • New murmur, fever ... #pain #differential
Skin Conditions Associated with Joint Pain

Rash
	• Human parvovirus B19 infection

Malar rash
	• SLE
	• Human parvovirus B19 infection
	•
• Rheumatic fever ... Sarcoidosis #dermatology ... #joint #pain #skin ... #rashes #differential ... #diagnosis #rheumatology
Clinical Features of Systemic Lupus (SLE)
General: Fever (50%), Depression, Fatigue (75%), Weight loss (50%)
Eye: Sjögrens (15%)
Skin
) General: Fever ... lesions Abdominal pain ... erythematosus #signs ... #symptoms #diagnosis ... #rheumatology
Clinical Manifestations of Serotonin Syndrome
 • Ophthalmologic: Mydriasis, Ocular clonus (slow horizontal movements)
 • Gastrointestinal: Diarrhea,
bowel sounds, RUQ pain ... • Dermatologic ... : Tachycardia, Fever ... #Symptoms #spectrum ... #signs #diagnosis
Approach to Joint Pain - Arthritis Differential Diagnosis Framework

Inflammatory Versus Noninflammatory Pain
 • Is it inflammatory
noninflammatory Signs ... constitutional symptoms ... • Rheumatic fever ... streptococci (rheumatic fever ... #pain #Differential
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 ... #Joint #Pain #MSK ... #rheumatology # ... approach #workup #differential
Purpura - Differential Diagnosis Framework

Non-blanchable, dark red to purple, hemorrhagic skin lesions that result from leakage
Purpura - Differential ... mountain spotted fever ... #Diagnosis #hematology ... #rheumatology # ... #nonpalpable #dermatology
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 ... Diagnosis #Management #Hematology ... #Rheumatology
Sweet Syndrome

Acute febrile neutrophilic dermatosis (Sweets Syndrome) is a skin condition characterized by fever and inflamed
characterized by fever ... Disorder: - Fever ... Episcleritis Signs ... - Fever - Fatigue ... arthralgia) - Fever
Systemic Lupus Erythematosus - Diagnosis
Manifestations:
 - Arthritis 69%
 - Malar rash 40%
 - Fever 36%
 -
Malar rash 40% - Fever ... autoantibodies #signs ... #symptoms #mimickers ... #differential # ... rheumatology