OzEMedicine - Wiki for Australian Emergency Medicine Doctors

see also:

• rheumatology

• see also arthritis - clinical patterns for more details on patterns of disease in arthritis
• the following is a quick aide memoire of the common conditions which cause joint swelling and some of their extra-articular manifestations which may provide clues to the diagnosis.

• pitting:
  • psoriasis

• alopecia, scalp lesions:
  • systemic lupus erythematosus (SLE), psoriasis
• pustular:
  • gonococcaemia; psoriasis;
• malar rash:
  • SLE, dermatomyositis
• extensor surfaces rash:
  • psoriasis
• dorsum hand rash:
  • dermatomyositis
• tightening of skin:
  • scleroderma
• erythema chronicum migrans:
  • Lyme disease
• hyperkeratotic lesions:
  • Reiter's syndrome
• generalised rash:
  • rubella
• tophi:
  • gout
• track marks:
  • IV drug abuse
• erythema marginatum:
  • rheumatic fever
• subcutaneous nodules:
  • rheumatoid arthritis
• Raynaud's phenomenon:
  • 95% of pts with scleroderma
  • 25% of pts with Sjögren's syndrome, systemic lupus erythematosus (SLE) or dermatomyositis
  • 5% of pts with rheumatoid arthritis
  • NB. Primary Raynaud disease

• dryness:
  • Sjogren's syndrome
• iritis/uveitis:
  • seronegative spondyloparthropathies:
  • severe in Behcet's; pauciarticular ANA +ve JCA;
  • common in ankylosing spondylitis, Reiter's syndrome
  • rare in psoriatic arthropathy
  • HLA-B27 idiopathic
  • gonorrhoea
• conjunctivitis:
  • Reiter's syndrome
• icterus:
  • hepatitis

• dryness:
  • Sjogren's syndrome
• ulcerations:
  • SLE, Reiter's syndrome

• interstitial fibrosis:
  • scleroderma
• pleuritis:
  • SLE, RhA

• friction rubs:
  • RhA, SLE
• murmurs:
  • SBE, RhA

• hepatomegaly:
  • hepatitis
  • inflammatory bowel disease

• peripheral neuropathy/mononeuritis multiplex:
  • vasculitis

• urethral discharge/lesions:
  • Reiter's; gonococcal;