Arthropathy DDx

Arthropathy – Differential Diagnosis

Common causes

• Reactive viral arthritis
• Osteoarthritis
• Fibromyalgia
• Psoriatic arthropathy
• Gout

Must Not Miss

• Septic arthritis
• Connective tissue diseases
  • Rheumatoid arthritis
  • PMR
  • SLE
  • Scleroderma
  • Polymyositis
• Malignancy
  • Metastases
  • Bone tumours
  • Leukaemia/ Lymphoma
• Infection
  • HIV
  • Tuberculosis
  • Rheumatic fever
  • Bacterial Endocarditis
• Compartment syndrome

Easily missed

• Medication
• Spondyloarthropathies
  • Ankylosing spondylitis
  • Crohn’s dis/ Ulcerative colitis
  • Lyme disease
  • Sarcoidosis

Red flags

• Hot/painful/swollen joint with little movement
• Trauma or bleeding disorder
• Systemic symptoms (fever and weight loss)
• Rest pain or nocturnal pain
• Associated weakness and deformities
• Local skin infections

Investigations to consider

• FBC, CRP/ESR
• U&Es, LFTs, Serum uric acid
• Auto antibody screen, Rheumatoid factor
• PSA
• Viral screen
• Mantoux test
• Joint X-ray
• CXR
• Bone scan
• Joint aspirate
• Synovial biopsy

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