Differential Diagnosis of Joint Pain Lecture Powerpoint Flashcards
Red flags of joint pain (4)
- acute onset of pain, weakness, numbness
- fever (not just infectious in origin but also rheumatic)
- history of cancer
- underlying bleeding disorder
Joint emergency surgeries (5)
- septic joint surgical washout
- compartment syndrome fasciotomy
- acute myelopathy by impingement repair
- Amputation in severe necrotic bone dz
- metastatic cancer removal
Septic joints are a bigger concern in native joints or prosthetic joints? How does this relate to dental cleaning
Prosthetic because the bacteria more easily accumulate on the artificial surface - concern in dental cleaning that dislodging bacteria in the gums might seed them into circulation and into a joint infection
Older adults can often get septic joints from asymptomatic untreated ____
UTI
Niesseria gonorrhea first line treatment
-Ceftriaxone and azithromycin or doxy
Septic joint vs bursitis
Bursa are outside the joint space and can swell up either infectious or not and typically treated with aspiration if not infectious, otherwise just treat with anti-inflammatories and monitor if it goes down, not nearly as severe or needing of surgery as septic
Only way to diagnose gout definatively is…
….microscopic analysis of crystals of joint fluid
Statin induced myalgia
Muscle aches, soreness, weakness that can be a complication of statin use early on, typically resolves but can be severe causing rhabdo in worst cases
Hemarthrosis
Blood withdrawn upon centesis of a joint
If seen a patient and done an x ray and its negative but have inflammation/joint effusion of knee is present next step is important to get….
….labs for inflammatory markers
Synovial fluid analysis of cell count ___ is inflammatory (septic, gout, spondyloarthritis)
2000 (200 is non)
Small amounts of blood intermittently during joint aspiration is a sign of…
….nicked vessel or damage upon process, NOT a sign of significant blood presence in the fluid
