21 results
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 ... #joint #pain #skin ... differential #diagnosis #rheumatology
Approach to Joint Pain - Diagnostic Framework

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

1) Chronicity:
), RA, crystal disease ... spondyloarthropathies, lupus ... Inflammatory, crystalline disease ... Like in this case ... #rheumatology #
Clinical Features of Systemic Lupus (SLE)
General: Fever (50%), Depression, Fatigue (75%), Weight loss (50%)
Eye: Sjögrens (15%)
Skin
Features of Systemic Lupus ... phenomenon (20%) Joints ... pain (20%) Renal disease ... erythematosus #signs ... symptoms #diagnosis #rheumatology
Systemic Lupus Erythematosus - Diagnosis
Manifestations:
 - Arthritis 69%
 - Malar rash 40%
 - Fever 36%
 -
Arthritis 69% - Malar ... auto-immune, Infectious diseases ... sclerosis, Still's disease ... autoantibodies #signs ... #differential #rheumatology
Diagnostic Framework for Hemolysis - Intravascular vs Extravascular Causes
Intravascular Hemolysis:
 • Mechanical Trauma (Microangiopathic hemolytic anemia):
Extravascular Causes ... usually IgG) (e.g. lupus ... • Infections: Malaria ... Extravascular #Causes ... differential #diagnosis #hematology
Causes of Bone/Joint Pain in Sickle Cell Disease
Vaso-occlusive pain:
 • Mechanism: ischemic pain
 • Can present
Causes of Bone/Joint ... in Sickle Cell Disease ... common sites: hip, shoulder ... Pain #SickleCell #Disease ... #hematology
THE LIMPING OR NON-WEIGHT BEARING CHILD PATHWAY

RED FLAGS - In all cases there are specific
markers which
FLAGS - In all cases ... suspicion of severe disease ... and these should ... Rheumatology ... discrepancy, multiple joint
Systemic Lupus Erythematosus (SLE) - Diagnosis and Management Summary
 • Epidemiology: 10-180/100,000, Typically Age 20-40, F:M
Systemic Lupus Erythematosus ... Manifestations: Malar ... Positive in 60-80% of cases ... Evolution: Chronic disease ... Management #Summary #rheumatology
SLE (Systemic Lupus Erythematosus)

Suspect:
Clinical evidence of (fatigue, rash, photosensitivity, inflammatory arthritis, weight loss, and fever) and
Non-autoimmune rheumatologic ... Arthritis: • Joint ... arthropathy • 90% joints ... Photosensitivity • Malar ... Erythematosus #Diagnosis #Rheumatology
Drug Induced Lupus vs SLE
Drug Induced Lupus (DIL):
 • Epidemiology: -10% of all lupus cases, drug-dependent,
& NPSLE rare, Malar ... Discontinuation of causal ... Manifestations: Malar ... Evolution: Chronic disease ... comparison #table #rheumatology