Episode 65 – Acute Joint Pain

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 April 29, 2022

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