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rheumatology differential cppd pain approach comparison management monoarthritis monoarticular polyarthritis polyarticular pseudogout signs testing algorithm arthropathies arthropathy autoimmune chondrocalcinosis classification
Approach to Joint Pain History: Is the pain from: • Joint • Adjacent bursa • Tendon • Ligament • Bone • Muscle • Referred from
or nerve root Symptoms ... of Joint Disease ... #Pain #MSK #rheumatology ... #approach #workup ... #differential #diagnosis
Joint Disorders - Differential Diagnosis Algorithm Monoarthritis • Septic • Crystalline - Gout
- Differential Diagnosis ... “Pseudogout” - Calcium ... should have other symptoms ... #Disorders #msk ... #Differential #Diagnosis
Approach to Joint Pain - Diagnostic Framework 1) Chronicity 2) Inflammatory vs Non-Inflammatory 3) Number of Joints Involved 1) Chronicity:
Pain - Diagnostic ... ), RA, crystal disease ... #Joint #Pain #MSK ... #rheumatology # ... approach #workup
Rheumatology Workup - Laboratories Studies in Rheumatic Diseases • Septic arthritis - Gram stain and culture of
Rheumatology Workup ... crystals (gout) or calcium ... profile (e.g., calcium ... #laboratory #workup ... #diagnosis #testing
Chondrocalcinosis: Calcium Pyrophosphate Dihydrate (CPPD) Deposition Disease - Acute CPPD precipitation into the joint space ->
Chondrocalcinosis: Calcium ... polyarticular arthritis ... affected — e.g., wrist ... #Signs #Symptoms ... Pathophysiology #Diagnosis
CPPD vs Gout == CPPD == Think About CPPD When: • Self-limited synovitis after surgery/trauma (> 65
(shoulders, wrists ... • Underlying disease ... precipitates with calcium ... Gout #Comparison #rheumatology ... #Diagnosis
Approach to Joint Pain - Arthritis Differential Diagnosis Framework Inflammatory Versus Noninflammatory Pain • Is it inflammatory
Differential Diagnosis ... constitutional symptoms ... Rheumatologic Disease ... #Diagnosis #MSK ... #rheumatology #
Pseudogout Summary - Calcium Pyrophosphate Deposition Disease (CPPD) Pathophysiology: Pyrophosphate produced by chondrocytes likely precipitates with calcium to
swelling in weird joints ... (shoulders, wrists ... culture used to diagnose ... #Rheumatology # ... diagnosis #management
Systemic Sclerosis (Scleroderma) Multi-system autoimmune disease characterized by vasculopathy and progressive fibrosis of skin and internal organs 3
Multi-system autoimmune disease ... distal to elbows/wrists ... Musculoskeletal: joint ... #diagnosis #signs ... #workup
Drug Induced Lupus vs SLE Drug Induced Lupus (DIL): • Epidemiology: -10% of all lupus cases, drug-dependent,
Constitutional symptoms ... , Arthritis, myalgia ... thiazidic, PPI, ACE, calcium-b ... Evolution: Chronic disease ... #diagnosis #management
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