8 results
Approach to Joint Pain

History:
Is the pain from:
	• Joint
	• Adjacent bursa
	• Tendon
	• Ligament
	• Bone
	• Muscle
	• Referred from
Adjacent bursa • Tendon ... present both at rest ... -60 minutes or longer ... e.g., congenital hip ... #Pain #MSK #rheumatology
Approach to Joint Pain - Diagnostic Framework

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

1) Chronicity:
warm, swollen, tender ... Lyme), reactive arthritis ... - parvovirus, HIV ... #Joint #Pain #MSK ... #rheumatology #
Distinguishing between Inflammatory and Degenerative joint disease
Inflammatory Joint Disease
 • Swelling stimulates joint nociceptors -> Pain
nociceptors -> Pain with rest ... in Rheumatoid arthritis ... tend to bear the ... affects the knee hip ... Comparison #Versus #MSK
Greater Trochanteric Bursa Injection 

Usually roll patient on side, find the most tender spot, approximately an
find the most tender ... joint. ... injection lasts longer ... video #procedure #rheumatology ... #sports #msk #orthopedics
Vasculitis and Vasculitides - Differential Diagnosis Framework

When to Consider Vasculitis:
 • Purpura, ischemic skin lesions
 •
vesicular eruption - Joints ... diminished, or tender ... retinopathy Lab Tests ... Cryoglobulins • HIV ... differential #diagnosis #rheumatology
Vasculitis - Differential Diagnosis Framework

When to Consider Vasculitis:
• Purpura, ischemic skin lesions
• Mononeuritis multiplex
• Hematuria, proteinuria,
diminished, or tender ... of shoulder and hip ... vesicular eruption • Joints ... Palpable purpura, joint ... Differential #Diagnosis #Rheumatology
Gout - Diagnosis and Management Summary

3 Conditions for Gout to Manifest:
1. Hyperuricemia
2. Monosodium urate deposition in
deposition in joints ... ankles, knees, fingers ... frequent attacks • Arthritis ... elbows, Achilles tendon ... management #treatment #rheumatology
Autoimmune Myositis - Differential Diagnosis Framework

Inflammatory Myopathies: Commonly symmetric proximal muscle weakness, no substantial muscle pain
Diagnostic Tests ... Syndrome: Fever, joint ... weakness + atrophy- Hip ... flexors, quadriceps, finger ... • Nonerosive arthritis