Diagnosis and Management of Acute Joint Pain in the Emergency Department

Points and Pearls Excerpt

• There are 6 broad categories of arthritis (with some overlap): (1) infectious, (2) degenerative, (3) autoimmune, (4) crystal deposition-related, (5) reactive, and (6) traumatic.
• Although joint pain has traditionally been thought of as either monoarticular or polyarticular, do not eliminate a disease based solely on these binary classifications, as some can present with single or multiple joints.
• The number of affected joints, their locations, and symmetry of distribution can help identify the cause of the joint pain. (See Table 2.)
• There are no disease-modifying treatments for osteoarthritis; symptom relief is the main focus. Intra-articular injections of corticosteroids or hyaluronic acid can be performed in the ED.
• Pregnant and menstruating women and patients with a complement deficiency are most at risk for gonococcal arthritis. Antibiotic recommendations for gonococcal arthritis were updated by the CDC in 2020.