44 results
Approach to Joint Pain - Diagnostic Framework

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

1) Chronicity:
acute rheumatic fever ... spondyloarthropathies, lupus ... #rheumatology # ... approach #workup ... #differential #
Myositis and Myopathies
Polymyositis 
 • Progressive, symmetric muscle weakness 
 • Elevated CK, +Anti-Jo, +Anti-Mi2
Dermatomyositis
, Fever, No muscle ... uncommon 5-15% of lupus ... Myopathies #myopathy #differential ... #diagnosis #comparison ... #rheumatology
Inflammatory Joint Pain - Differential Diagnosis Algorithm 
Monoarticular
 • Gout (Podagra, Tophi)
 • Pseudogout
 • Early
Pain - Differential ... Diagnosis Algorithm ... • Rheumatic Fever ... Arthritis • Systemic Lupus ... • Rheumatic Fever
Causes of Fever of Unknown Origin (FUO) - Differential Diagnosis
 • Infection: Extrapulmonary tuberculosis, Abscess, Endocarditis,
Causes of Fever ... tuberculosis, Abscess ... Brucellosis, Q fever ... . autoimmune): Lupus ... , Factitious fever
Skin Conditions Associated with Joint Pain

Rash
	• Human parvovirus B19 infection

Malar rash
	• SLE
	• Human parvovirus B19 infection
	•
Associated with Joint ... • Rheumatic fever ... lesions • Discoid lupus ... #skin #rashes #differential ... #diagnosis #rheumatology
Clinical Features of Systemic Lupus (SLE)
General: Fever (50%), Depression, Fatigue (75%), Weight loss (50%)
Eye: Sjögrens (15%)
Skin
Features of Systemic Lupus ... (SLE) General: Fever ... phenomenon (20%) Joints ... signs #symptoms #diagnosis ... #rheumatology
EULAR/ACR Classification Criteria for Systemic Lupus Erythematosus
Clinical Domains:
 • Constitutional domain: Fever
 • Cutaneous domain: Non-scarring
Criteria for Systemic Lupus ... Constitutional domain: Fever ... in at least 2 joints ... Erythematosus #diagnosis ... #rheumatology
Systemic Lupus Erythematosus - Diagnosis
Manifestations:
 - Arthritis 69%
 - Malar rash 40%
 - Fever 36%
 -
Malar rash 40% - Fever ... (aPL) 30-45% Differential ... Diagnosis and Lupus ... symptoms #mimickers #differential ... #rheumatology
Top 10 situations when to think about lupus
1) Inflammatory joint pain (especially in the wrists and
) Inflammatory joint ... the face (many differential ... diagnoses, including ... 9) Unexplained fever ... erythematosus #rheumatology
Extra-articular and Other Conditions Associated with Joint Pain

Eyes
  • Iritis or uveitis - Spondyloarthropathies, Sarcoidosis,
Hyperthyroidism Fever ... • Rheumatic fever ... SLE, Rheumatic fever ... • New murmur, fever ... #diagnosis #rheumatology