S2D: The Symptom to Diagnosis Podcast Joint Pain
Mar 3, 2021
Join the hosts as they dissect a perplexing case of a 60-year-old plumber grappling with chronic hand pain. They delve into the nuances of diagnosing rheumatoid arthritis versus other inflammatory conditions. Key discussions highlight the importance of distinguishing between periarticular and true joint pain, while emphasizing tailored testing approaches. Listeners will learn about chronic CPPD's deceptive similarities to OA and RA, and gain insight into diagnosing gout with its classic features. Tune in for thought-provoking clinical pearls and essential exam techniques!
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Distinguish Periarticular From Joint Pain
- Differentiate periarticular syndromes from true joint disease by focused exam and range of motion testing.
- Palpate for a single point of maximal tenderness to identify bursitis, epicondylitis, or nerve entrapment.
Tap Inflamed Monoarticular Joints
- For monoarticular problems first decide inflammatory versus noninflammatory by inspection and comparing symmetry and heat.
- If monoarticular and inflammatory, perform arthrocentesis unless you have a compelling reason not to.
Use Time Course For Polyarthritis
- For polyarticular disease, time course (acute/subacute vs chronic) is the most useful discriminator.
- Acute polyarthritis favors infectious or postinfectious causes, while chronic suggests rheumatologic disease.
