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Approach to Joint Pain - Diagnostic Framework

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

1) Chronicity:
Approach to Joint ... 3) Number of Joints ... weight-bearing joints ... Number of Joints ... ): • Septic joint
Approach to Joint Pain

History:
Is the pain from:
	• Joint
	• Adjacent bursa
	• Tendon
	• Ligament
	• Bone
	• Muscle
	• Referred from
Approach to Joint ... pain from: • Joint ... root Symptoms of Joint ... • Fatigue Joint ... categories of joint
Approach to Joint Pain - Arthritis Differential Diagnosis Framework

Inflammatory Versus Noninflammatory Pain
 • Is it inflammatory
Approach to Joint ... • How many joints ... OLIGOARTHRITIS • 2-4 joints ... POLYARTHRITIS • 5 or more joints ... #Arthritis #Joint
Extra-articular and Other Conditions Associated with Joint Pain

Eyes
  • Iritis or uveitis - Spondyloarthropathies, Sarcoidosis,
Associated with Joint ... Heberden's nodes (DIP joints ... Bouchard's nodes (PIP joints ... Extrarticular #conditions #joint
Skin Conditions Associated with Joint Pain

Rash
	• Human parvovirus B19 infection

Malar rash
	• SLE
	• Human parvovirus B19 infection
	•
Associated with Joint ... #dermatology #joint
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 ... 3rd MCP and PIP joints ... 5% of times Joint
Leg Pain - Differential Diagnosis Framework

Bone/Joint Causes of Leg Pain:
 • Fracture
 • Arthritis
 • Gout/pseudogout
Framework Bone/Joint ... onset - Intense joint ... Inability to move the joint
Rheumatology Workup - Laboratories Studies in Rheumatic Diseases

• Septic arthritis - Gram stain and culture of
spondylitis - Sacroiliac joint ... of the affected joint ... • Sacroiliac joint
SLE (Systemic Lupus Erythematosus)

Suspect:
Clinical evidence of (fatigue, rash, photosensitivity, inflammatory arthritis, weight loss, and fever) and
Arthritis: • Joint ... arthropathy • 90% joints
Amyloidosis - Summary
Group of disorders associated with extracellular deposition of fibrils formed from low-molecular-weight proteins in
wasting Bone/Joint