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Monoarthritis

Beschreibung

Algorithm for the investigation of monoarthritis
laurenkkelly
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Zusammenfassung der Ressource

Monoarthritis
  1. Complete history and examination
    1. Suspect joint trauma / injury
      1. Effusion/synovitis present
        1. Arthrocentesis
          1. Crystals
            1. MSU
              1. Gout
              2. CPPD
                1. Pseudogout
              3. WBC <2000
                1. Suspect non-inflammatory conditions eg. OA
                2. WBC >2000
                  1. Suspect inflammatory causes eg. RA, JIA, spondyloarthropathies, SLE, septic arthritis etc.
                    1. Synovial fluid gram stain, culture, sensitivity
                      1. Pathogens
                        1. Septic arthritis
                        2. No pathogens
                          1. ESR and CRP
                            1. Patterns indicative of certain disease vs generalised elevation
                            2. RF and CCP
                              1. Positive
                                1. Suspect rheumatoid arthritis
                                2. Negative
                                  1. Rheumatoid arthritispossible but consider other aetiologies
                                3. ANA
                                  1. Positive
                                    1. ENA and dsDNA
                                      1. Positive
                                        1. Suspect SLE
                                        2. Negative
                                          1. SLE unlikely, consider other aetiologies
                                      2. Negative
                                        1. SLE unlikely, consider other aetiologies
                              2. Haemarthrosis
                                1. Imaging
                                  1. Coagulopathy profile
                                3. No effusion/synovitis
                                  1. Radiograph
                                    1. Fracture, tumour, osteonecrosis
                                4. Suspect soft tissue problem
                                  1. Ultrasound
                                  2. Suspect mechanical joint problem
                                    1. RA, CCP, arthrocentesis, ESR
                                      1. Positive
                                        1. Osteoarthritis unlikely, consider other aetiologies
                                        2. Negative
                                          1. Suspect osteoarthritis
                                        3. Radiograph
                                        4. Suspect inflammatory joint problem
                                        5. Findings
                                          1. Investigation
                                            1. Condition
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