Joint Disorders - Differential Diagnosis Algorithm
Monoarthritis
• Septic
• Crystalline
- Gout - Uric Acid Crystals
- “Pseudogout” - Calcium Pyrophosphate Dihydrate Crystals
Spondyloarthropathies
• Ankylosing spondylitis - “Bamboo Spine” Fusion of Lumbar Spine and SI Joints
• Reactive arthritis - (Reiter’s syndrome) Aseptic, within 1 month of infection elsewhere. “Molecular Mimicry”
• Psoriatic arthritis - with the skin disorder psoriasis (7-30%)
• Inflammatory Bowel Disease - Arthropathy with Crohn’s Disease, Ulcerative Colitis (2-20%) Undifferentiated
Polyarthritis
• Osteoarthritis (OA) - Degradation of articular cartilage (inflammation is secondary)
• Rheumatoid Arthritis (RA) - Inflammation of Synovium Membrane - pannus formation, systemic autoimmune disease, Symmetric Polyarthritis
• Systemic Lupus - with Systemic Lupus Erythematosus (SLE), should have other symptoms like “butterfly rash”
- Amy Chung, MD, MSc @AmyChung
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