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clinical
» Rheumatology
Arthritis
Overview Once arthritis is suspected, physicians should distinguish between noninflammatory and inflammatory forms of arthritis while recognizing potentially disabling and life-threatening problems.
Remember Rule out septic arthritis in any monoarthritic presentation, prolonged diagnosis results in irreversible joint damage |
Definition Polyarthralgia: multiple joint pain without synovities Polyarthritis: inflammation of 4 or more joints (synovitis) |
Monoarthropathy | Oligoarthropathy | Polyarthropathy |
Septic arthritis | Crystal arthritis | Rheumatoid arthritis |
Crystal arthritis (Gout) | Psoriatic arthritis | Viral Arthritis |
Osteoarthritis (can be mono-poly) | Reactive arthritis | Autoimmune connective tissue disease (ie. SLE) |
Trauma (Haemarthrosis) | Ankylosing spondylititis | Vasculitides (ie. Polymyalgia Rheumatica) |
Approach
- History
- Sex
- Age of onset
- Pattern of arthritis
- Extra-articular features
- Which joints affected
- peripheral symmetrical arthritis - Rheumatoid arthritis
- Asymmetric with enthesitis and back pain - spondylarthritis
- DIP joints with synovitis - psoriatic arthritis
Age | |
Child | Trauma, Congenital, slipped capital femoral epihpysis, Juvenile rheumatoid arthritis |
Young Adults | Reactive arthritis, gonococcal, SLE |
Older patients | Acute gout and Pseudogout, Rheumatoid arthrits |
- Examination
- Psoraiasis
- Malar rash - SLE
- Kerataderma blenorrhagica - Septic arthritis
- Salmon
- Investigations
Differential Diagnosis
Arthritis can be divided into:
- Acute or chronic
- Monoarthritis, Oligoarthritis, Polyarthritis
- Inflammatory and non-inflammatory
- Seropositive or seronegative
Non-inflammatory Arthritis
Inflammatory Arthritis
- Crystal arthropathy
- Infectious
- Seronegative arthritis
- Ankylosing spondylitis
- Psoriatic arthritis
- Reactive arthritis
- IBD arthritis
- Seropositive arthritis
- Rheumatoid Arthritis
- Scleroderma
- Vasculitis
- Sjogren's