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Is the joint pain localized to a single joint? Localization to a single joint should suggest a septic arthritis, gout, tuberculosis, hemophilia, sickle cell disease, trauma, avascular necrosis, and pseudogout. ... DIAGNOSTIC WORKUP
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Is it painless? The presence of joint swelling without pain, especially on motion, would suggest Charcot's disease.
Is the involvement primarily in small or large joints? Involvement of the small joints is characteristic of ... DIAGNOSTIC WORKUP
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Is it diffuse or focal? Diffuse scrotal swelling would suggest congestive heart failure, nephrosis, uremia, and cirrhosis, as well as focal disease such as filariasis or bilateral hydrocele. Focal scrotal swelling ... DIAGNOSTIC WORKUP
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... A pulsatile swelling anywhere is an aneurysm until proven otherwise. However, frequently there is simply a benign or malignant tumor over a large artery that gives the false impression that the mass is an aneurysm when it is not. In the abdomen, a normal abdominal aorta... DIAGNOSTIC WORKUP
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Ankle pain is a common problem that generally occurs secondary to acute or chronic injury or degenerative joint disease. Ankle sprains, most commonly due to traumatic inversion injury, are the most common cause of ankle pain. In cases of trauma, the Ottawa rules... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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The elbow joint is formed by the radius, ulna, and distal humerus. Trauma is a common cause of injury. Injuries frequently result from falling on an outstretched hand and may be associated with nerve injuries (axillary, radial, ulnar, and/or median... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Jaw pain is a common presenting or incidental complaint; its etiology is often identified by a careful history and physical examination. In many cases, consultation with a dentist will aid in the diagnosis and treatment. In older patients (>55), be sure to rule out... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Primary care physicians, rheumatologists, and orthopedists frequently encounter complaints about the knee. Because the range of illnesses affecting the knee varies greatly, a thorough history and physical exam are essential. Once a differential diagnosis is compiled, plain films of the... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Low back pain is the second most common cause of doctor visits in the U.S. and is the most common cause of disability. Up to 90% of the population will experience back pain during their lives. Studies show that, at any given time, up to 20% of the... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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The shoulder is a complex arrangement of the humerus held loosely in place by ten muscles acting on the scapula, clavicle, and humerus, which form three articulations (acromioclavicular, glenohumeral, and sternoclavicular). Acute injuries are... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Toe pain and swelling can be caused by local processes such as infection or trauma, or it may be a symptom of a systemic disorder, such as rheumatoid arthritis, endocarditis, or atherosclerotic vascular disease. Gout, or podagra, is the most... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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The wrist is composed of eight carpal bones that are held in alignment by a series of ligaments and cartilaginous connective tissue. Wrist pain is fairly common in primary care. Although carpal tunnel syndrome is one of the most common etiologies of wrist pain, pain and numbness in the hand... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Clinical history and physical examination is a fundamental diagnostic tool in polyarthritis. Laboratory findings of inflammation include anemia, elevated ESR, CRP, and thrombocytosis. Normal or low platelet count, elevated LDH and uric acid levels... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Arthritis in a single joint, or monoarthritis, is a difficult diagnostic challenge, because any disorder affecting joints may initially present as monoarthritis. After establishing that the arthritis is truly monoarticular, the most important considerations are septic joint and trauma.... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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A scrotal mass may or may not be detected by the patient or the patient's parent. Many are discovered by the clinician during routine physical examinations. Most scrotal masses seen in infants are hydroceles and inguinal hernias; both are more... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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... Because most joints may be affected by the same etiologic processes, a general discussion of the differential diagnosis of joint pain will be undertaken, followed by a discussion of exceptions that apply to certain joints.
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... The best approach to analysis of this symptom is anatomic and histologic ( Table 43 ). However, if one remembers the biochemical causes of joint disease, gout, pseudogout, and ochronosis immediately come to mind.
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... Scrotal swelling occurs when a condition affecting the testicles, epididymis, or scrotal skin produces edema or a mass; the penis may be involved. Scrotal swelling can affect males of any age. It can be unilateral or bilateral and painful or painless. ... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers
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... Juvenile rheumatoid arthritis
Ankylosing spondylitis
Rheumatoid arthritis (rare)
Systemic diseases
Psoriasis
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... Rheumatoid arthritis*
Juvenile rheumatoid arthritis*
Rheumatic fever*
Ankylosing spondylitis*
Collagen-vascular diseases
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... A chronic, systemic, inflammatory disease, rheumatoid arthritis (RA) primarily attacks peripheral joints and surrounding muscles, tendons, ligaments, and blood vessels. Spontaneous remissions and unpredictable exacerbations mark the course of... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
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... Neurogenic arthropathy, also called Charcot’s arthropathy, is a progressively degenerative disease of peripheral and axial joints, resulting from impaired sensory innervation. The loss of sensation in the joints causes progressive deterioration, resulting from... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
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... Affecting children younger than age 16, juvenile rheumatoid arthritis (JRA) is an inflammatory disorder of the connective tissues, characterized by joint swelling and pain or tenderness. It may also involve organs such as the skin, heart, lungs, liver, spleen, and eyes, producing extra... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment
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... Psoriatic arthritis is a rheumatoid-like joint disease associated with psoriasis of nearby skin and nails. Although the arthritis component of this syndrome may be clinically indistinguishable from rheumatoid arthritis, the rheumatoid nodules are absent, and serologic tests... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
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... Septic, or infectious, arthritis is a medical emergency that occurs when bacterial invasion of a joint causes inflammation of the synovial lining, effusion and pyogenesis, and destruction of bone and cartilage. Septic arthritis can lead to ankylosis and even fatal septicemia.... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
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... Scrotal swelling occurs when a condition affecting the testicles, epididymis, or scrotal skin produces edema or a mass; the penis may be involved. Scrotal swelling can affect males of any age. It can be unilateral or bilateral and painful or... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
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Meredith A. Goodwin
Arthralgia is a general term that describes pain in one or more joints, with or without joint inflammation. The source can be local or systemic. Pain location, onset, duration, and associated symptoms are important data in determining the... Approach ... History ... Physical examination ... Testing ... Diagnostic assessment ... Pictures
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... Margaret A. Tryforos
Approach Evaluation of monarticular joint pain should differentiate inflammatory from degenerative conditions and clarify whether immediate treatment is needed to prevent permanent joint damage. Distinction... History ... Physical examination ... Testing ... Diagnostic assessment ... Pictures
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... Differential Overview
❑ Injury
❑ Gout
❑ Osteoarthritis
❑ Lyme disease
❑ Gonococcal arthritis ... Diagnostic Approach ... Clinical Findings
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... Differential Overview
❑Lyme disease
❑Erythema nodosum
❑Rheumatoid arthritis
❑Systemic lupus erythematosus
❑Psoriatic arthritis ... Clinical Findings
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... Differential Overview
❑ Osteoarthritis
❑ Rheumatoid arthritis
❑ Lyme arthritis
❑ Systemic lupus erythematosus ... Diagnostic Approach ... Clinical Findings ... Pictures
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... Differential Overview
Pain Predominant
❑ Epididymitis
❑ Testicular torsion
❑ Prostatitis
❑... Diagnostic Approach ... Clinical Findings
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... A chronic, systemic inflammatory disease, rheumatoid arthritis (RA) primarily attacks peripheral joints and surrounding muscles, tendons, ligaments, and blood vessels. Partial remissions and unpredictable exacerbations mark the course of this potentially crippling disease. ... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
... READ EXCERPTS »
... Most common in men older than age 40, neurogenic arthropathy (Charcot’s arthropathy) is a progressively degenerative disease of peripheral and axial joints, resulting from impaired sensory innervation. The loss of sensation... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
... READ EXCERPTS »
... Affecting children younger than age 16, juvenile rheumatoid arthritis (JRA), also known as juvenile chronic arthritis, is an immune-mediated inflammatory disorder of the connective tissues characterized by joint swelling and pain or tenderness. It may also... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
... READ EXCERPTS »
... Psoriatic arthritis is a rheumatoid-like joint disease associated with psoriasis of the skin and nails. Although the arthritis component of this syndrome may be clinically indistinguishable from rheumatoid arthritis, the rheumatoid nodules are absent, and serologic tests for... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
... READ EXCERPTS »
... A medical emergency, septic (infectious) arthritis is caused by bacterial invasion of a joint, resulting in inflammation of the synovial lining. If the organisms enter the joint cavity, effusion and pyogenesis follow, with eventual destruction of... Causes ... Signs and symptoms ... Treatment ... Special considerations
... READ EXCERPTS »
... Scrotal swelling occurs when a condition affecting the testicles, epididymis, or scrotal skin produces edema or a mass; the penis may be involved. Scrotal swelling can affect males of any age. It can be unilateral or bilateral and painful or painless. ... Assessment ... History ... Physical examination ... Pediatric pointers ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
... READ EXCERPTS »
... Scrotal swelling occurs when a condition affecting the testicles, epididymis, or scrotal skin produces edema or a mass; the penis may be involved. Scrotal swelling can affect males of any age. It can be unilateral or bilateral and painful or painless.
... Emergency Actions ... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... Scrotal swelling occurs when a condition affecting the testicles, epididymis, or scrotal skin produces edema or a mass; the penis may be involved. Scrotal swelling can affect males of any age. It can be unilateral or bilateral and painful or painless.
The sudden onset of... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
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Because most joints may be affected by the same etiologic processes, a
general discussion of the differential diagnosis of joint pain will be
undertaken, followed by a discussion of exceptions that apply to certain
joints.
Anatomic and histologic... Pictures
... READ EXCERPTS »
...
The best approach to analysis of this symptom is anatomic and
histologic (Table 43). However,
if one remembers the biochemical causes of joint disease, gout, pseudogout,
and ochronosis immediately come to mind.
Let us... Pictures
... READ EXCERPTS »
... Samir S. Shah, Jacqueline Owusu-Antwi, and Lisa B. Zaoutis
Approach to the Patient with Back, Joint, and Extremity Pain
I. Definition of the Complaint
... Pictures
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... I. History of Present Illness
A 2-year-old boy presented to the emergency department for evaluation of back
pain. Three days before admission, he began to complain of abdominal pain,
refused to eat lunch that ... Pictures
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... I. History of Present Illness
A 2-year-old boy presented with a 2-week history of difficulty walking. The
parents had noticed that he would no longer run while playing with his
siblings. Over the past ... Pictures
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... I. History of Present Illness
A 14-year-old boy presented to the emergency department complaining of left knee
pain. Three days before this visit, he noted left knee pain after playing
basketball and began to limp. This knee pain improved over ... Pictures
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... I. History of Present Illness
A 16-year-old girl was admitted with joint pain and a 35-pound weight loss over
the preceding 7 months. After completion of her gymnastics season 7 months
before admission, she ... Pictures
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... I. History of Present Illness
A 13-year-old African-American boy without significant past medical history
presented to the emergency department with a 2-day history of worsening back
pain. The pain was located in his upper ... Pictures
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I. History of Present Illness
In the winter of his 9th year of life, a very active young boy presented to his
pediatrician with left ankle pain of ... Pictures
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... Author:
Michael Clemmens, MD
What to Do - Interpret the Data
Perform a thorough physical exam and consider radiographs of both the area
in question, as well as those areas proximal and distal.
Lower... Suggested Readings ... Pictures
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Conventional medical treatments for arthritis have come a long way in recent years. But many people suffering from arthritis pain have found...
In this segment, Dr. Allan Gibofsky answers viewer you questions about arthritis. Is there a connection between arthritis and fibromyalgia?