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arthralgia
Joint pain.
Etiology:
1) arthritis
2) bursitis
3) trauma
4) reaction to medication
Epidemiology:
- no association with rain [1]
Clinical manifestations:
- pain with both active & passive range of motion implies intrinsic joint disease [3]
- pain with only active range of motion suggests periarticular pathology [3]
Laboratory:
1) anti-nuclear antibody (ANA)
2) rheumatoid factor (RF)
3) serum C-reactive protein (serum CRP)
4) erythrocyte sedimentation rate (ESR)
5) serum thyroid-stimulating hormone (serum TSH)
Radiology:
1) x-ray of affected joint(s)
2) magnetic resonance imaging as indicated
Management:
1) if duration of arthralgias > 3 months, initiate diagnostic workup
2) trial of steroids, prednisone 40 mg PO QD for 6 days
3) return to clinic in one week
-> if good response to prednisone & seronegative (ANA, RF), begin hydroxychloroquine (9 month trial)
4) also see arthritis, bursitis
Related
arthritis
bursitis
Useful
hydroxychloroquine (Plaquenil)
prednisone (Deltasone, Orasone, Liquid Pred, Meticortin, Rayos)
Specific
lower leg joint pain
myalgia/arthralgia as part of multisystem disease
polyarthralgia
General
musculoskeletal pain
References
- Jena AB, Newhouse RL, Olenski AR et al
Association between rainfall and diagnoses of joint or back pain:
retrospective claims analysis.
BMJ 2017;359:j5326
PMID: 29237605
http://www.bmj.com/content/359/bmj.j5326
- Schaible HG, von Banchet GS, Boettger MK et al
The role of proinflammatory cytokines in the generation and
maintenance of joint pain.
Ann N Y Acad Sci. 2010 Apr;1193:60-9.
PMID: 20398009
- Medical Knowledge Self Assessment Program (MKSAP) 17,
American College of Physicians, Philadelphia 2015