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diagnosis rheumatology pain approach knee workup autoimmune causes classification clinical comparison degenerative dislocation effusions erythematosus extremity inflammatory injury jointdisease jointpain
Approach to Joint Pain History: Is the pain from: • Joint • Adjacent bursa • Tendon • Ligament • Bone • Muscle • Referred from
trauma (e.g., meniscal ... e.g., congenital hip ... osteopetrosis, avascular ... #Pain #MSK #rheumatology ... approach #workup #differential
Approach to Joint Pain - Diagnostic Framework 1) Chronicity 2) Inflammatory vs Non-Inflammatory 3) Number of Joints Involved 1) Chronicity:
spondyloarthropathies, lupus ... Non-bloody: OA, avascular ... - parvovirus, HIV ... #Joint #Pain #MSK ... approach #workup #differential
Distinguishing between Inflammatory and Degenerative joint disease Inflammatory Joint Disease • Swelling stimulates joint nociceptors -> Pain
in Rheumatoid arthritis ... , Lupus, etc) -> ... affects the knee hip ... > Stiffness is short-lived ... Comparison #Versus #MSK
Causes of Knee Effusions - Differential Diagnosis Framework Knee Effusion Red Flags: 1. Fever/Chills/Joint pain/Night sweats/Weight loss - DDX: -
Knee Effusions - Differential ... Fever/Chills/Joint ... Ligamentous injuries - Meniscal ... #diagnosis #msk ... #physicalexam
Leg Pain - Differential Diagnosis Framework Bone/Joint Causes of Leg Pain: • Fracture • Arthritis • Gout/pseudogout
Leg Pain - Differential ... Herpes zoster - HIV ... #Leg #pain #differential ... lower #extremity #msk ... #physicalexam
SLE (Systemic Lupus Erythematosus) Suspect: Clinical evidence of (fatigue, rash, photosensitivity, inflammatory arthritis, weight loss, and fever) and
, inflammatory arthritis ... permanent alopecia Differential ... Joint pain • Swan ... arthropathy • 90% joints ... • Malar rash - spares
Vasculitis and Vasculitides - Differential Diagnosis Framework When to Consider Vasculitis: • Purpura, ischemic skin lesions •
inflammation Others: • Lupus ... eruption - Joints ... such as systemic lupus ... retinopathy Lab Tests ... Cryoglobulins • HIV
Posterior Knee Dislocation Injury Specifically, POSTERIOR KNEE DISLOCATIONS can have significant associated injury that needs unique approach
nerve injury (25%) TEST ... Check hip and ankle ... joints for associated ... special ligament/meniscus ... Posterior #Injury #msk
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 Autoimmune Myositis - Differential Diagnosis Framework Inflammatory Myopathies: Commonly symmetric proximal muscle weakness, no substantial muscle pain
Autoimmune Myositis - Differential ... Diagnostic Tests ... : Fever, joint pain ... weakness + atrophy- Hip ... • Nonerosive arthritis
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