Episode 65 – Acute Joint Pain

Interview with author: Rachel Sullivan, MD

• Why joint pain ?
• Differential Diagnosis
• Mono vs Poly Articular Presentation? Figure 1
• Infectious, degenerative, autoimmune, crystal deposition, reactive, traumatic
• Septic Arthritis-
• Bimodal incidence
• Risks
• Septic arthritis is polyarticular in 15% to 20% of cases, and in these cases, the mortality is high
• Gonococcal
• Highest risk
• Commonly affected joints
• Symptomatic or asymptomatic infection
• Lyme Arthritis
• Viral – Zika, chikungunya, human parvovirus B19, hepatitis
• Degenerative osteoarthritis
• Autoimmune
• Gout
• CPPD
• Prehospital
• ED History – table 2, table 4
• ED exam
• Labs – do we need them?
• Imaging
• Arthrocentesis – Table 5
• Treatment
• Special Populations
• Prostheses
• Immunocompromised
• HIV
• Clinical Pathway