Ravi Singh K @rav7ks
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Academic Hospitalist and Program Director @SinaiBmoreIMRes, Medicine clerkship director GW School of Medicine and Health Sciences RMC at Sinai, Clinical reasoning,Simulation and POCUS enthusiast - https://twitter.com/rav7ks
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Chest Pain - Differential Diagnosis Framework

Cardiovascular Causes of Chest Pain:
 • Myocardium:
	- Myocarditis
	- CAD/ACS
	- Valvulopathy
	- Myopericarditis
Chest Pain - Differential ... Causes of Chest Pain ... Causes of Chest Pain ... Causes of Chest Pain ... Cholecystitis #Chest #Pain
Chronic Abdominal Pain Causes - Differential Diagnosis Framework

Many patients with chronic abdominal pain have had prior
Chronic Abdominal Pain ... chronic abdominal pain ... Chronic Abdominal Pain ... weight loss • Pain ... Epigastric/LUQ Pain
Leg Pain - Differential Diagnosis Framework

Bone/Joint Causes of Leg Pain:
 • Fracture
 • Arthritis
 • Gout/pseudogout
Leg Pain - Differential ... Causes of Leg Pain ... Patellofemoral pain ... Causes of Leg Pain ... Causes of Leg Pain
Approach to Joint Pain - Arthritis Differential Diagnosis Framework

Inflammatory Versus Noninflammatory Pain
 • Is it inflammatory
Approach to Joint Pain ... Noninflammatory Pain ... < 30 mins • Pain ... Waking up with pain ... at night Pain
Approach to Joint Pain

History:
Is the pain from:
	• Joint
	• Adjacent bursa
	• Tendon
	• Ligament
	• Bone
	• Muscle
	• Referred from
Approach to Joint Pain ... History: Is the pain ... Joint Disease: • Pain ... arthritis: - Pain ... arthritis: - Pain
Ear Pain (Otalgia) - Differential Diagnosis Framework

Primary Otalgia 
 - Pain that originates from the ear
Ear Pain (Otalgia ... Primary Otalgia - Pain ... from the ear - Pain ... - Intermittent pain ... Down Ddx: • Pain
Skin Conditions Associated with Joint Pain

Rash
	• Human parvovirus B19 infection

Malar rash
	• SLE
	• Human parvovirus B19 infection
	•
Associated with Joint Pain ... Schönlein purpura • PAN ... dermatology #joint #pain
Extra-articular and Other Conditions Associated with Joint Pain

Eyes
  • Iritis or uveitis - Spondyloarthropathies, Sarcoidosis,
Associated with Joint Pain ... Vasculitis (e.g., PAN ... conditions #joint #pain
Approach to Joint Pain - Diagnostic Framework

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

1) Chronicity:
Approach to Joint Pain ... #Joint #Pain #MSK
Miosis Causes - 4 P's Mnemonic
Constricted: pupils < 2mm, Pinpoint: pupils < 1mm
 • Pain Killer:
pupils < 1mm • Pain