Episode 65 – Acute Joint Pain

Take a deeper dive into our peer-reviewed emergency medicine content with the EMplify podcast. Join hosts Sam Ashoo, MD and T.R. Eckler, MD for educational, conversational reviews of current evidence guaranteed to help you make your best clinical decisions. Each high-yield episode gives you practical, time-tested guidance from practicing emergency medicine clinicians and subject-matter experts. Listen and learn!

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Episode 65 – Acute Joint Pain

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Diagnosis and Management of Acute Joint Pain in the Emergency Department

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

Last Updated on January 25, 2023

Sam Ashoo, MD

Sam Ashoo, MD, FACEP,  is board certified in emergency medicine and clinical informatics. He serves as EB Medicine’s editor-in-chief of interactive clinical pathways and FOAMEd blog, and host of EB Medicine’s EMplify podcast. Follow him below for more…