Medicine an Surgery notes

Apr 24th, 2015
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APPROACH TO PAINFUL JONTHistoryEvaluation of Pain-Nature of onset of joint pain, frequency -With inflammatory joint disease, the pain is present both at rest and with motion. It is worse at the beginning of usage as opposed to at the end of usage. -With non inflammatory (ie, degenerative, traumatic, or mechanical) joint disease, the pain occurs mainly or only during motion and improves quickly with rest.-Localization of pain within the joint or associated myalgia or bone pain-deep joint pain(synovitis) or superficial joint pain(soft tissue injuries, tendon injuries)-Referral of pain to other joints.-Number of joints that are painful.AssociationsFever-infective-septic arthritis or restive arthritisStiffness Stiffness is a perceived sensation of tightness when attempting to move joints after a period of inactivity-With inflammatory arthritis, the stiffness is present upon waking and typically lasts 30-60 minutes or longer. -With non inflammatory arthritis, stiffness is experienced briefly (eg, 15 min) upon waking in the morning or following periods of inactivity. -Prolonged morning stiffness that does not involve the hands and feet should prompt consideration of a diagnosis other than RA.Swelling With inflammatory arthritis, joint swelling is related to synovial hypertrophy, synovial effusion, and/or inflammation of periarticular structures. The degree of swelling often varies over time. With noninflammatory arthritis, the formation of osteophytes leads to

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