Joint pain 2

Question 1

What are the differentials for polyarthritis (5 or more joints)?

Answer 1

RA
Seronegative arthritis 
Post viral arthritis 
SLE
Arthritis ass with UC/Crohn's, SLE
Sjogrens syndrome 
Reiter's syndrome

Question 2

What are the investigations for inflammatory polyarthritis?

Answer 2

FBC, ESR, CRP, U&E, LFT
ANA, anti-dsDNA (SLE), RF, anti-Rho, anto-La (Sjogrens)
X-rays
Bone biochemistry, TFTs, viral titres, urinalysis, contrast study, barium enema, sigmoidoscopy

Question 3

What are the four features to differentiate when a patient presents with polyarthralgia?

Answer 3

early morning stiffness
pain
swellings
systemic features

Question 4

What are the different types of early morning stiffness?

Answer 4

less than 30 mins = non-inflammatory
more than 60 mins = non-inflammatory
between 30-60mins = more likely to be inflammatory

Question 5

How should pain be assessed?

Answer 5

worse with activity?
background pain?
pain at rest?
does the pain fully go away ?

Question 6

How should swellings be assessed?

Answer 6

hard = bone = inflammatory 
rubbery = joint capsule = inflammatory 
fluctuant = effusion = inflammatory

Question 7

In which conditions are systemic features common?

Answer 7

inflammatory conditions