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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 ... #differential #
Skin Conditions Associated with Joint Pain

Rash
	• Human parvovirus B19 infection

Malar rash
	• SLE
	• Human parvovirus B19 infection
	•
Malar rash • SLE ... • Rheumatic fever ... Antiphospholipid-antibody syndrome ... #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 ... (20%) Renal disease ... erythematosus #signs ... #rheumatology
Erythematous Rashes - THE ALGORITHMIC APPROACH

Characterized by diffuse redness of the skin due to
capillary congestion, erythematous
or absence of fever ... If fever is present ... includes Kawasaki disease ... , scarlet fever, ... but without a fever
Causes of Pericardial Effusion - Differential Diagnosis
Infectious:
 • Viral: Enterovirus, Herpesvirus, Adenovirus, Parvovirus
 • Bacterial: Mycobacterium
Non-Infectious: • Rheumatologic ... : SLE, Rheumatoid ... Mediterranean Fever ... : EGPA, Horton Disease ... , Takayasu Disease
Macrophage Activation Syndrome (MAS)
Classified among the secondary or acquired forms of haemophagocytic lymphohistiocytosis (sHLH)

What?
A subset of
• Periodic fever ... multiorgan failure • Fever ... - Nonremitting fever ... erythematosus [SLE ... #Rheumatology
Systemic Lupus Erythematosus - Diagnosis
Manifestations:
 - Arthritis 69%
 - Malar rash 40%
 - Fever 36%
 -
Malar rash 40% - Fever ... autoantibodies #signs ... #symptoms #mimickers ... #differential # ... rheumatology
Inflammatory Joint Pain - Differential Diagnosis Algorithm 
Monoarticular
 • Gout (Podagra, Tophi)
 • Pseudogout
 • Early
Inflammatory Joint Pain ... - Differential ... • Rheumatic Fever ... Sicca) Syndrome ... • Rheumatic Fever
Approach to Headaches - Differential Diagnosis Algorithm

Red flags (PHANTOMS):
 • Pattern change, progressively worse, papilledema
 •
Diagnosis Algorithm ... papilledema • Horner syndrome ... ) • Systemic symptoms ... , fever, myalgia ... #neurology #PHANTOMS
Causes of Proteinuria - Differential Diagnosis Algorithm
Persistent Proteinuria >150mg/d protein present on repeat testing including overnight
Diagnosis Algorithm ... • Exercise • Fever ... • Fanconi's syndrome ... (MPA) • SLE ... Minimal change disease