DSA11 - Arthralgia WITHOUT Primary
Systemic Inflammation
Describe signs of Joint Infection - ANS Fever, pain on passive and active ROM, Hot/Swollen Joints,
Superficial cutaneous changes, Recent bacteremia
Define Arthritis - ANS Joint Pain with inflammation
Define Arthralgia - ANS Joint Pain without inflammation
Define Monoarthritis - ANS Arthritis of one joint
Define Pauci-arthritis/Oligo-arthritis - ANS Arthritis of 2-4 joints
Deifne Polyarthritis - ANS Arthritis in at least 5 joints
Describe Sx of Inflammatory Arthritis - ANS Morning stiffness lasting > 30-60 minutes, Fever, Fatigue,
Malaise, Weight Loss
Describe Signs of Inflammatory Arthritis - ANS Synovitis (tenderness, inflammation of synovial
membrane, palpable synovium), warmth/erythema, soft tissue swelling/effusion
Describe Lab Findings of Inflammatory Arthritis - ANS Synovial Fluid WBC > 2000/uL, Elevated ESR/CRP -
signs of chronic disease, thrombocytosis
Infectious arthritis can be () or () depending on organism - ANS rapid; prolonged
, What social hx can lead to Infectious Arthritis? - ANS Use of Alcohol, IV drug use, recent hosp/sick
contacts
What are some PE signs to look for Infectious arthritis? - ANS Periarticular >> articular inflammation,
Mono > Oligo > Polyarthritis, Joint effusion/warmth, Ballottement
Define Ballottement (Patellar Tap Test) - ANS patella will float or bounce back on palpation, sign of joint
effusion
Define Peri-Articular Joint Pain - ANS Pain in surrounding soft tissue - aka outside joint (muscle, bursa,
ligament, tendon)
Define Articular/Mono-articular Joint Pain - ANS Pain with direct palpation of joint line & with passive
and active ROM
What are associated signs to look for Infectious arthritis? - ANS Rash (ex: Gonococcal), Cardiac Murmur,
Splinter Hemorrhages (ex: Endocarditis), Tophi (ex: Gout), Conjunctival erythema (ex: reactive arthritis)
Define Joint Aspiraiton - ANS Most impt lab test for mono-articular joint pain; mandatory if infection is
suspected (attempt in all patients with effusion or sign of inflammation)
What is the purpose of a Joint Aspiration? - ANS Evaluates whether the effusion is inflammatory,
infected, bloody, contains crystals or is bland (Get synovial CBC - WBC w/ differential, crystal analysis,
gram stain and culture)
Describe the Synovial Fluid Analysis of Noninflamamtory Synovial Fluid - ANS > 3.5 mL, High Viscosity,
Clear Clarity, Straw/Yellow Color, < 2000 WBC
Describe the Synovial Fluid Analysis of Inflamamtory Synovial Fluid - ANS > 3.5 mL, Low Viscosity, Cloudy
Clarity, Yellow Color, > 2000 WBC
Systemic Inflammation
Describe signs of Joint Infection - ANS Fever, pain on passive and active ROM, Hot/Swollen Joints,
Superficial cutaneous changes, Recent bacteremia
Define Arthritis - ANS Joint Pain with inflammation
Define Arthralgia - ANS Joint Pain without inflammation
Define Monoarthritis - ANS Arthritis of one joint
Define Pauci-arthritis/Oligo-arthritis - ANS Arthritis of 2-4 joints
Deifne Polyarthritis - ANS Arthritis in at least 5 joints
Describe Sx of Inflammatory Arthritis - ANS Morning stiffness lasting > 30-60 minutes, Fever, Fatigue,
Malaise, Weight Loss
Describe Signs of Inflammatory Arthritis - ANS Synovitis (tenderness, inflammation of synovial
membrane, palpable synovium), warmth/erythema, soft tissue swelling/effusion
Describe Lab Findings of Inflammatory Arthritis - ANS Synovial Fluid WBC > 2000/uL, Elevated ESR/CRP -
signs of chronic disease, thrombocytosis
Infectious arthritis can be () or () depending on organism - ANS rapid; prolonged
, What social hx can lead to Infectious Arthritis? - ANS Use of Alcohol, IV drug use, recent hosp/sick
contacts
What are some PE signs to look for Infectious arthritis? - ANS Periarticular >> articular inflammation,
Mono > Oligo > Polyarthritis, Joint effusion/warmth, Ballottement
Define Ballottement (Patellar Tap Test) - ANS patella will float or bounce back on palpation, sign of joint
effusion
Define Peri-Articular Joint Pain - ANS Pain in surrounding soft tissue - aka outside joint (muscle, bursa,
ligament, tendon)
Define Articular/Mono-articular Joint Pain - ANS Pain with direct palpation of joint line & with passive
and active ROM
What are associated signs to look for Infectious arthritis? - ANS Rash (ex: Gonococcal), Cardiac Murmur,
Splinter Hemorrhages (ex: Endocarditis), Tophi (ex: Gout), Conjunctival erythema (ex: reactive arthritis)
Define Joint Aspiraiton - ANS Most impt lab test for mono-articular joint pain; mandatory if infection is
suspected (attempt in all patients with effusion or sign of inflammation)
What is the purpose of a Joint Aspiration? - ANS Evaluates whether the effusion is inflammatory,
infected, bloody, contains crystals or is bland (Get synovial CBC - WBC w/ differential, crystal analysis,
gram stain and culture)
Describe the Synovial Fluid Analysis of Noninflamamtory Synovial Fluid - ANS > 3.5 mL, High Viscosity,
Clear Clarity, Straw/Yellow Color, < 2000 WBC
Describe the Synovial Fluid Analysis of Inflamamtory Synovial Fluid - ANS > 3.5 mL, Low Viscosity, Cloudy
Clarity, Yellow Color, > 2000 WBC
