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Approach to Joint Pain

History:
Is the pain from:
	• Joint
	• Adjacent bursa
	• Tendon
	• Ligament
	• Bone
	• Muscle
	• Referred from
• Inflammatory arthritis ... Noninflammatory arthritis ... with rheumatoid arthritis ... other inflammatory arthritides ... oxalate Infectious Arthritis
Arthritis of the Hand - Arthritis Patterns

Osteoarthritis:
• Osteoarthritis of the hand usually involves the DIP and
Arthritis of the ... Hand - Arthritis ... Rheumatoid Arthritis ... • Rheumatoid arthritis ... Pencil in cup • Arthritis
Approach to Joint Pain - Arthritis Differential Diagnosis Framework

Inflammatory Versus Noninflammatory Pain
 • Is it inflammatory
to Joint Pain - Arthritis ... • Psoriatic arthritis ... • Reactive arthritis ... • Lyme arthritis ... #Arthritis #
Approach to Joint Pain - Diagnostic Framework

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

1) Chronicity:
Lyme), reactive arthritis ... SLE, psoriatic arthritis ... differential #diagnosis #arthritis
Rheumatology Workup - Laboratories Studies in Rheumatic Diseases

• Septic arthritis - Gram stain and culture of
Diseases • Septic arthritis ... of Inflammatory Arthritis ... when rheumatoid arthritis ... diagnosis of reactive arthritis ... Disease #Rheumatoid #Arthritis
Extra-articular and Other Conditions Associated with Joint Pain

Eyes
  • Iritis or uveitis - Spondyloarthropathies, Sarcoidosis,
Juvenile idiopathic arthritis ... Onycholysis - Psoriatic arthritis ... Pitting - Psoriatic arthritis ... Tumor-associated arthritis ... , Takayasu's arteritis
Behçet's Syndrome
Systemic disease associated with inflammation of multiple organs, small-vessel vasculitis and large-vessel vasculopathy
Epidemiology:
 • Young
myocarditis, coronary arteritis ... SLE, Reactive arthritis ... Ocular melanoma • Arthritis ... SLE, Reactive Arthritis ... Recurrent and chronic arthritis-Azathioprine
Skin Conditions Associated with Joint Pain

Rash
	• Human parvovirus B19 infection

Malar rash
	• SLE
	• Human parvovirus B19 infection
	•
• Gonococcal arthritis ... blennorrhagicum • Reactive arthritis ... • Psoriatic arthritis
Leg Pain - Differential Diagnosis Framework

Bone/Joint Causes of Leg Pain:
 • Fracture
 • Arthritis
 • Gout/pseudogout
• Fracture • Arthritis ... pain syndrome • Arthritis ... Poikilothermia • Septic arthritis
Adult Onset Still's Disease
Systemic inflammation with urticarial rash.
Rash: 
 • Nonpruritic, evanescent (correlates with time of
early evening • Arthritis ... Arthralgias or arthritis