678 results
Approach to Joint Pain - Diagnostic Framework

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

1) Chronicity:
Approach to Joint ... mycobacterial), RA, crystal ... Number of Joints ... culture, look for crystals ... psoriatic arthritis Crystals
Chondrocalcinosis: Calcium Pyrophosphate Dihydrate (CPPD) Deposition Disease

 - Acute CPPD precipitation into the joint space ->
precipitation into the joint ... Inflammatory response to crystals ... Repeated subacute crystal ... precipitation into joint ... selected MCP/PIP joints
Gout: Pathogenesis and Clinical Findings
 - Conditions of rapid cell turnover: hemolysis, psoriasis, lymphoproliferative disorders
 -
easily leaks into joints ... in a peripheral joint ... Neutrophils enter joint ... phagocytose the crystal ... Needle-shaped uric acid crystals
Arthrocentesis - Joint Fluid Analysis

Effusion Characteristics (Color, Clarity, WCC, PMN, Crystals, Bacteria) by Disease Process: 
OA,
Arthrocentesis - Joint ... Clarity, WCC, PMN, Crystals ... positively birefringent crystals ... negatively birefringent crystals ... Arthrocentesis #Joint
CPPD vs Gout

== CPPD == 

Think About CPPD When:
 • Self-limited synovitis after surgery/trauma (> 65
swelling in weird joints ... Acute CPP Crystal ... MCP, or shoulder joints ... deposition in joints ... attacks • Other joints
Joint Disorders - Differential Diagnosis Algorithm
Monoarthritis
 • Septic
 • Crystalline
     - Gout
Joint Disorders ... Gout - Uric Acid Crystals ... Pyrophosphate Dihydrate Crystals ... Lumbar Spine and SI Joints ... @AmyChung #Joint
Pseudogout: pathogenesis and clinical findings
 - Idiopathic (vast majority of cases) -> Mechanism unknown
 - Familial
dihydrate (CPPD) crystals ... from joints is ... x-ray - CPPD Crystals ... birefringent (crystals ... warm, swollen joint
Gouty arthritis of the shoulder joint

50 yo male presented with shoulder pain.

Note double contour sign at
of the shoulder joint ... deposition of crystal ... POCUS #Ultrasound #Crystals
Arthritis of the Hand - Arthritis Patterns

Osteoarthritis:
• Osteoarthritis of the hand usually involves the DIP and
the DIP and PIP joints ... the PIP and MCP joints ... but not the DIP joints ... 5% of times Joint ... Psoriatic arthritis, crystal-induced
Approach to Joint Pain

History:
Is the pain from:
	• Joint
	• Adjacent bursa
	• Tendon
	• Ligament
	• Bone
	• Muscle
	• Referred from
Approach to Joint ... pain from: • Joint ... categories of joint ... inflammatory arthritides Crystal ... ochronosis and crystal