Joint Pain & Swelling

 

• DDx: Monoarthropathy

  Acute:

  • Crystal arthropathy: gout, CPPD (pseudogout).
  • Infection: septic (Staph. aureus, N. gonnorhea), TB, Lyme.
  • Trauma, haemarthrosis, avascular necrosis.
  • Palindromic RA.
  • Seronegative arthritis: psoriatic, reactive, IBD-associated.
  • Multi-system disease: SLE, sarcoidosis.

  Chronic:

  • Osteoarthritis
  • Malignancy

• DDx: Oligoarthropathy (2-4 joints)

  • Reactive arthritis
  • Psoriatic arthritis
  • Crystal arthropathy.
  • Juvenile idiopathic arthritis (if age <16).

• DDx: Polyarthropathy (≥5 joints)

  Joint diseases:

  • Rheumatoid arthritis.
  • Nodal osteoarthritis.
  • Seronegative arthritis, especially psoriatic arthritis and reactive arthritis.
  • Juvenile idiopathic arthritis (if age <16).
  • Crystal arthropathy and septic arthritis, though more commonly monoarticular.
  • Parvovirus

  Multi-system diseases:

  • Immune-mediated: SLE, systemic sclerosis, polymyositis/dermatomyositis, autoimmune liver disease, sarcoidosis, Behcet's, Sjögren's, vasculitis.
  • Infectious endocarditis.
  • Marfan's and Ehlers-Danlos.
  • Haematological: sickle cell disease, haemochromatosis, leukaemia