Joint Pain Differential Diagnosis Table

There are many joints in our body which allow mobility and strength. joints can be painful anywhere in the body, but those who are allowing free movements with heavy load are more susceptible for example Hip, knee and shoulder joints.

Joint pain can be caused by a number of different inflammatory and non inflammatory diseases.
They are different types of Arthritis, Spondylitis and Gout.

Every specific disease that causes joint pain can be distinguished from others by its signs and symptoms. Psoriatic arthritis, reactive arthritis, and ankylosing spondylitis can be distinguished from rheumatoid arthritis by negative rheumatoid factor results.

In psoriatic arthritis we can find scaly red patches called erythema on the patient’s skin plus the pattern of inflammations it causes.
Reactive Arthritis can be identified as beside joint pain and inflammation of the joint, it also causes inflammation of the front protective layer of the eye called the conjunctivitis and urethritis.

Spondylitis is presented with back pain that is caused by the inflammation due to ankylosing spondylitis resulting in the fusion of two vertebrae into one large giant bone causing severe pain and limiting the movements.
Joint pain with increased uric acid level in the blood is referred to as Gout.
Osteoarthritis causes joint pain without inflammation by wear and tear.

Joint Pain Differential Diagnosis Table:

Joint pain is some sort of discomfort experienced in one or more joints. Pain that is isolated to just one joint is monoarticular joint pain, while that isolated to many joints is called polyarticular joint pain. Common causes of single joint pain include injury, infection often caused by gonorrhea that has spread throughout the body, especially in the joints, inflammation, osteoarthritis, and destruction of part of the nearby bone caused by poor blood supply.
Common causes in many joints are arthritis, whether acute or chronic. Other causes outside the joint include fibromyalgia, polymyalgia rheumatica, bursitis, or tendinitis. Treatment usually involves dealing with the underlying condition. NSAIDs are given for inflammation, while acetaminophen is given for pain without inflammation to relieve symptoms. Physical therapy may be useful.

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How to Recognize if Osteoarthritis is Causing Joint Pain

Osteoarthritis is a degenerative joint disease where tissues of the joint break down over time, resulting in chronic joint pain, mostly in the knee joint. The joint pain is usually experienced after rest or inactivity or stiffness for a short period of time. There might also be occasional joint swelling.
Imaging tests on the joint usually reveal joint space narrowing and bone spurs.

How to Recognize if Rheumatoid Arthritis is Causing Joint Pain

Rheumatoid arthritis is an autoimmune condition that develops when the immune system does not work properly and attacks the lining of the joints, called the synovium. It commonly affects the joints of the hands, knees, and ankles and is usually bilateral.
Joint pain is usually accompanied by tenderness, swelling, or stiffness that lasts for 6 weeks or longer. Morning stiffness usually lasts for more than 30 minutes. Blood tests usually reveal the presence of rheumatoid factor. Imaging tests show bone erosion.

How to Recognize if Fibromyalgia is Causing Knee Pain

Fibromyalgia is an ongoing chronic condition that causes pain in tissues and muscles all over the body. Joint pain in fibromyalgia is often described as a dull ache that affects multiple joints, particularly in the neck, shoulders, hips, and knees. The pain can be intermittent or constant and may be accompanied by stiffness and swelling.

How to Recognize if Lupus is Causing Joint Pain

Systemic lupus erythematosus is a chronic multi-system inflammatory disorder of autoimmune cause, occurring predominantly in young women. Joint manifestations ranging from arthralgias and acute polyarthritis occur in 90% of patients. Deformities without bone erosions may develop.
Laboratory tests usually show a positive ANA test, anti-dsDNA and anti-Smith antibodies. Complement levels usually show low C3 and C4. Ultrasound may detect inflammation and joint effusion.

How to Recognize if Gout is Causing Joint Pain

Gout is a type of inflammatory arthritis that causes sudden and intense attacks on the joints, often in the big toe and at night. Gout attacks usually peak after 12-24 hours then slowly go away on their own whether treated or not.
There is always the presence of urate crystals on joint fluid analysis and high uric acid levels in the blood. There is also redness, swelling, and tenderness in the affected joint and recurrent episodes of joint pain with a similar pattern.

How to Recognize if Psoriatic Arthritis is Causing Joint Pain

Psoriatic arthritis is an inflammatory condition that occurs when the body’s immune system attacks healthy cells and tissues, causing inflammation in the joints as well as overproduction of skin cells.
The joint pain is usually asymmetrical in pattern and involves the toes, fingers, and spine. It also presents with some nail changes and skin lesions. Ultrasound detects enthesitis.

How To Recognize If Lyme Disease Is Causing Joint Pain

Lyme disease is a bacterial infection that is spread to humans from the bite of the deer tick caused by the bacterium Borrelia burgdorferi. Joint pain is usually experienced at the later stages. Other presentations usually include erythema migrans and flu-like symptoms. Laboratory results usually show a positive ELISA and Western blot.

Red Flags With Joint Pain

In people with pain in more than one joint, symptoms that should prompt rapid evaluation include:

• Joint swelling, warmth, and redness.
• New skin rashes, spots, purple blotches, or nail pitting.
• Sores in the mouth or nose or on the genitals.
• Chest pain, shortness of breath, or new or severe cough.
• Abdominal pain.
• Fever, sweats, weight loss, or chills.
• Eye redness or pain.

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