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Extra-articular and Other Conditions Associated with Joint Pain

Eyes
  • Iritis or uveitis - Spondyloarthropathies, Sarcoidosis,
Associated with Joint ... • Gout • ... Tophi - Gout ... syndrome - SLE Neurologic ... Heberden's nodes (DIP joints
Gout (Gouty Arthritis) - MSK Radiology
Imaging Findings:
 • Eccentric soft-tissue densities surrounding the third proximal interphalangeal
Gout (Gouty Arthritis ... mass and NO prior signs ... (RA, CPPD) - Can ... diffuse chondral disease ... #Gouty #Arthritis
CPPD vs Gout

== CPPD == 

Think About CPPD When:
 • Self-limited synovitis after surgery/trauma (> 65
CPPD vs Gout ... swelling in weird joints ... • Underlying disease ... states Pathophysiology ... : Resembles RA
Joint Disorders - Differential Diagnosis Algorithm
Monoarthritis
 • Septic
 • Crystalline
     - Gout
Joint Disorders ... Crystalline - Gout ... • Reactive arthritis ... (RA) - Inflammation ... #Disorders #msk
Approach to Joint Pain - Diagnostic Framework

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

1) Chronicity:
mycobacterial), RA ... , crystal disease ... Inflammatory, crystalline disease ... • Chronic = RA ... #Joint #Pain #MSK
Rheumatoid arthritis (RA): Pathogenesis and Joint diseases features
 • RA affects 1% of population, women >
Rheumatoid arthritis ... and Joint diseases ... Extra-articular signs ... #pathophysiology ... #signs #symptoms
Chondrocalcinosis: Calcium Pyrophosphate Dihydrate (CPPD) Deposition Disease

 - Acute CPPD precipitation into the joint space ->
) Deposition Disease ... polyarticular arthritis ... ) (tends to be out ... #Disease #Signs ... #Symptoms #Pathophysiology
Causes of Knee Effusions - Differential Diagnosis Framework

Knee Effusion Red Flags:
1. Fever/Chills/Joint pain/Night sweats/Weight loss
	- DDX:
		-
Fever/Chills/Joint ... - Pseudo gout ... - Juvenile RA ... Ligamentous injuries - Meniscal ... differential #diagnosis #msk
Approach to Joint Pain

History:
Is the pain from:
	• Joint
	• Adjacent bursa
	• Tendon
	• Ligament
	• Bone
	• Muscle
	• Referred from
Disease: • Pain ... disease must be ... (RA) and many other ... trauma (e.g., meniscal ... #Pain #MSK #rheumatology
Approach to Joint Pain - Arthritis Differential Diagnosis Framework

Inflammatory Versus Noninflammatory Pain
 • Is it inflammatory
noninflammatory Signs ... Crystal induced (Gout ... fever • Lyme • Gout ... Symmetrical: • RA ... #Diagnosis #MSK