18 results
Approach to Joint Pain - Diagnostic Framework

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

1) Chronicity:
Approach to Joint ... spondyloarthropathies, lupus ... Number of Joints ... #rheumatology # ... approach #workup #differential
Joint Disorders - Differential Diagnosis Algorithm
Monoarthritis
 • Septic
 • Crystalline
     - Gout
- Differential Diagnosis ... Polyarthritis • Systemic Lupus ... with Systemic Lupus ... Erythematosus (SLE), should ... Disorders #msk #Differential
Myositis and Myopathies
Polymyositis 
 • Progressive, symmetric muscle weakness 
 • Elevated CK, +Anti-Jo, +Anti-Mi2
Dermatomyositis
Anti-retrovirals, Gemcitabine Lupus ... uncommon 5-15% of lupus ... myopathy) VA Joint ... Myopathies #myopathy #differential ... diagnosis #comparison #rheumatology
Skin Conditions Associated with Joint Pain

Rash
	• Human parvovirus B19 infection

Malar rash
	• SLE
	• Human parvovirus B19 infection
	•
Associated with Joint ... B19 infection Malar ... lesions • Discoid lupus ... #skin #rashes #differential ... #diagnosis #rheumatology
Systemic Lupus Erythematosus - Diagnosis
Manifestations:
 - Arthritis 69%
 - Malar rash 40%
 - Fever 36%
 -
Systemic Lupus Erythematosus ... Arthritis 69% - Malar ... (aPL) 30-45% Differential ... symptoms #mimickers #differential ... #rheumatology
Causes of Bone/Joint Pain in Sickle Cell Disease
Vaso-occlusive pain:
 • Mechanism: ischemic pain
 • Can present
Causes of Bone/Joint ... common sites: hip, shoulder ... • Differentiate ... BrighamChiefs #Bone #Joint ... diagnosis #causes #hematology
Top 10 situations when to think about lupus
1) Inflammatory joint pain (especially in the wrists and
to think about lupus ... ) Inflammatory joint ... the face (many differential ... pericarditis » is...lupus ... erythematosus #rheumatology
Diagnostic Framework for Hemolysis - Intravascular vs Extravascular Causes
Intravascular Hemolysis:
 • Mechanical Trauma (Microangiopathic hemolytic anemia):
usually IgG) (e.g. lupus ... • Infections: Malaria ... Extravascular #Causes #differential ... #diagnosis #hematology
SLE (Systemic Lupus Erythematosus)

Suspect:
Clinical evidence of (fatigue, rash, photosensitivity, inflammatory arthritis, weight loss, and fever) and
permanent alopecia Differential ... Non-autoimmune rheumatologic ... Arthritis: • Joint ... arthropathy • 90% joints ... Photosensitivity • Malar
Approach to Joint Pain - Arthritis Differential Diagnosis Framework

Inflammatory Versus Noninflammatory Pain
 • Is it inflammatory
Pain - Arthritis Differential ... axial (spine, shoulders ... - Autoimmune Rheumatologic ... #pain #Differential ... Diagnosis #MSK #rheumatology