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Approach to Joint Pain - Diagnostic Framework 1) Chronicity 2) Inflammatory vs Non-Inflammatory 3) Number of Joints Involved 1) Chronicity:
Approach to Joint Pain ... arthritis, gout or pseudogout ... Spondyloarthropathies, gout, pseudogout ... Rhomboid, blue = pseudogout ... #Joint #Pain #MSK
Approach to Joint Pain - Arthritis Differential Diagnosis Framework Inflammatory Versus Noninflammatory Pain • Is it inflammatory
Approach to Joint Pain ... Noninflammatory Pain ... at night Pain ... induced (Gout/Pseudogout ... Lyme • Gout/Pseudogout
Leg Pain - Differential Diagnosis Framework Bone/Joint Causes of Leg Pain: • Fracture • Arthritis • Gout/pseudogout
Leg Pain - Differential ... Causes of Leg Pain ... Arthritis • Gout/pseudogout ... Patellofemoral pain ... Causes of Leg Pain
Inflammatory Joint Pain - Differential Diagnosis Algorithm Monoarticular • Gout (Podagra, Tophi) • Pseudogout • Early
Inflammatory Joint Pain ... Podagra, Tophi) • Pseudogout
Septic Arthritis - Diagnosis and Management Summary Clinical Exam: hot, swollen, pain with passive AND active ROM
hot, swollen, pain ... osteoarthritis, gout, pseudogout
Pseudogout Summary - Calcium Pyrophosphate Deposition Disease (CPPD) Pathophysiology: Pyrophosphate produced by chondrocytes likely precipitates with calcium to
Pseudogout Summary ... onset of swelling, pain ... chondrocalcinosis Acute Pseudogout ... with acute neck pain ... #Pseudogout #CPPD
Rheumatology Workup - Laboratories Studies in Rheumatic Diseases • Septic arthritis - Gram stain and culture of
fluid • Gout or pseudogout ... dihydrate crystals (pseudogout ... , and low back pain
Arthrocentesis - Joint Fluid Analysis Effusion Characteristics (Color, Clarity, WCC, PMN, Crystals, Bacteria) by Disease Process: OA,
arthritis SLE, , RF , Pseudogout ... Table #Aspiration #Pseudogout
Synovial Fluid Analysis: Findings (COLOR TRANSPARENCY VISCOSITY WBC COUNT (PER MM3) PMN CELL COUNT (%) GRAM STAIN CULTURE PCR TEST CRYSTALS) By Condition (Normal Noninflammatory Inflammatory:
Table #Aspiration #Pseudogout
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 Arthrocentesis of synovial fluid - Interpretation - Normal - Noninflammatory - Inflammatory - Septic Viscosity of synovial
Table #Aspiration #Pseudogout
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