Arthralgia: Difference between revisions

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{{Infobox_Disease
[[File:Under Construction.jpg|center|thumb]]
| Name          = {{PAGENAME}}
__NOTOC__
| Image          =
| Caption        =
| DiseasesDB    = 15237
| ICD10          = {{ICD10|M|25|5|m|20}}
| ICD9          = {{ICD9|719.4}}
| ICDO          =
| OMIM          =
| MedlinePlus    =
| eMedicineSubj  =
| eMedicineTopic =
| MeshID        = D018771
}}
{{SI}}
{{SI}}
{{CMG}}
{{CMG}}; {{AE}}[[User:DrMars|Mohammadmain Rezazadehsaatlou[2]]].


{{JFS}}
{{EH}}
==Overview==
==Overview==
'''Arthralgia''' (from Greek ''arthro-'', joint + ''-algos'', pain) literally means ''joint pain''; <ref name="medterms_arthralgia">
'''Arthralgia''' (from Greek ''arthro-'', joint + ''-algos'', pain) literally means joint pain; <ref name="medterms_arthralgia">
{{cite web  
{{cite web |url=http://www.medterms.com/script/main/art.asp?articlekey=2343|title= Arthralgia Definition|accessdate=2007-09-20|format= HTML|work=MedicineNet.com }}</ref><ref name="jgh_arthralgia"> {{cite web|url=http://www.ncbi.nlm.nih.gov/books/bv.fcgi?indexed=google&rid=cm.chapter.4738|title= Arthralgia|author=Joe G. Hardin|accessdate=2007-09-20|format= HTML|work=Clinical Methods - The History, Physical, and Laboratory Examinations }}</ref>  it is a symptom of injury, [[infection]], illnesses in particular [[arthritis]] or an [[allergic reaction]] to medication.<ref name="drugReaction" > {{cite web |url=http://www.ncbi.nlm.nih.gov/books/bv.fcgi?highlight=arthralgia&rid=cm.chapter.5910#5949  
|url=http://www.medterms.com/script/main/art.asp?articlekey=2343  
|title= Allergic Drug Reactions - Systemic Allergic Drug Reactions|author=James R Philp|accessdate=2007-09-20|format= HTML|work=Clinical Methods - The History, Physical, and Laboratory Examinations  }}</ref>
|title= Arthralgia Definition  
According to [[MeSH]], the term arthralgia should only be used when the condition is non-inflammatory, and the term arthritis should be used when the condition is inflammatory.<ref name="title">{{cite web|url=http://www.nlm.nih.gov/cgi/mesh/2008/MB_cgi?field=uid&term=D018771 |title=MeSH |accessdate=2007-12-23 |format= |work=}}</ref>
|accessdate=2007-09-20  
|format= HTML  
|work=MedicineNet.com }}</ref><ref name="jgh_arthralgia"> {{cite web |url=http://www.ncbi.nlm.nih.gov/books/bv.fcgi?indexed=google&rid=cm.chapter.4738  
|title= Arthralgia  
|author=Joe G. Hardin  
|accessdate=2007-09-20  
|format= HTML  
|work=Clinical Methods - The History, Physical, and Laboratory Examinations }}</ref>  it is a symptom of injury, infection, illnesses  
-- in particular [[arthritis]]-- or an allergic reaction to medication.<ref name="drugReaction" > {{cite web |url=http://www.ncbi.nlm.nih.gov/books/bv.fcgi?highlight=arthralgia&rid=cm.chapter.5910#5949  
|title= Allergic Drug Reactions - Systemic Allergic Drug Reactions
|author=James R Philp
|accessdate=2007-09-20  
|format= HTML  
|work=Clinical Methods - The History, Physical, and Laboratory Examinations  }}</ref>
 
According to [[MeSH]], the term "arthralgia" should only be used when the condition is non-inflammatory, and the term "arthritis" should be used when the condition is inflammatory.<ref name="title">{{cite web |url=http://www.nlm.nih.gov/cgi/mesh/2008/MB_cgi?field=uid&term=D018771 |title=MeSH |accessdate=2007-12-23 |format= |work=}}</ref>
 
==Diagnosis and Causes==
Diagnosis involves interviewing the patient and performing physical exams. When attempting to establish the cause of the arthralgia, the emphasis is on the interview <ref name="jgh_arthralgia"/>.  The patient is asked questions intended to narrow the number of potential causes. Given the varied nature of these possible causes, the questions may strike the uninitiated as irrelevant.  For example the patient may be asked about dry mouth, light sensitivity, rashes or a history of seizures.<ref name="jgh_arthralgia"/>  <ref name="spondyl_table1" > {{cite web |url=http://www.ncbi.nlm.nih.gov/books/bv.fcgi?highlight=arthralgia&rid=cm.chapter.5910#5949
|title=  Table 159.3.  Selected Symptomatic Extraarticular Features of the Connective Tissue Diseases and the Spondyloarthropathies
|accessdate=2007-09-20
|format= HTML
|work=Clinical Methods - The History, Physical, and Laboratory Examinations  }}</ref>
Answering yes or no to any of these questions limits the number of possible causes and guides the doctor toward the appropriate exams and lab tests.


The causes of ''arthralgia'' are varied and range from, a joints perspective, degenerative and destructive processes such as [[Arthritic|osteoarthritis]] and sports injuries to inflammation of tissues surrounding the joints (e.g. [[bursitis]], a painful inflammation of bursa, fluid filled sacks around the joints). <ref name="nihbook_2">{{cite web  |url=http://www.ncbi.nlm.nih.gov/books/bv.fcgi?indexed=google&rid=cm.chapter.4738  
==Causes==
The causes of arthralgia are varied and range from, a joints perspective, degenerative and destructive processes such as [[Arthritic|osteoarthritis]] and sports injuries to inflammation of tissues surrounding the joints (e.g. [[bursitis]], a painful inflammation of bursa, fluid filled sacks around the joints). <ref name="nihbook_2">{{cite web  |url=http://www.ncbi.nlm.nih.gov/books/bv.fcgi?indexed=google&rid=cm.chapter.4738  
|title= Table 161.1.  Some Common Regional Rheumatic Syndromes
|title= Table 161.1.  Some Common Regional Rheumatic Syndromes
|author=Joe G. Hardin  
|author=Joe G. Hardin  
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|work=Clinical Methods - The History, Physical, and Laboratory Examinations }}</ref>
|work=Clinical Methods - The History, Physical, and Laboratory Examinations }}</ref>


==Treatment==
===Common Causes===
Treatment depends on specific underlying cause. The underlying cause will be treated first and foremost. The treatments may include joint replacement surgery, for severely damaged joints, immunosuppressants for immune system dysfunction, antibiotics when an infection is the cause, and discontinuing medication when an allergic reaction is the cause. When treating the primary cause, pain management may still play a role in treatment. The extent of its role varies depending on the specific cause of the ''arthralgia''. Pain management may include stretching exercises, over the counter pain medications, prescription pain medication, or other treatments deemed appropriate for the symptoms.
* [[Behcet's disease]]
* [[Chikungunya virus]]
* [[Crohn's disease]]
* [[Dengue fever]]
* [[Gout]]
* [[Osteoarthritis]]
* [[Rheumatoid arthritis]]
* [[Rheumatic fever]]
* [[Ross river virus]]
* [[Lupus erythematosus]]
* [[Tenosynovitis]]
* [[Ulcerative colitis]]
* Medication like [[terconazole]]
 
===Causes by Organ System===
{|style="width:80%; height:100px" border="1"
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" |  [[Dressler's syndrome]]
|-
|-bgcolor="LightSteelBlue"
| '''Chemical / poisoning'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Dermatologic'''
|bgcolor="Beige"|[[Blau syndrome]], [[Ehlers-Danlos syndrome]], [[Erythema elevatum diutinum]], [[Lepromatous leprosy]], [[Lipoid dermatoarthritis]], [[Lupus erythematosus]], [[Lyme disease]], [[Mixed connective tissue disease]], [[scleroderma]], PAPA syndrome, [[Pyoderma gangrenosum]], [[Rheumatic Fever]], [[Scleroderma]],[[syphilis]], [[Sweet's disease]], [[Systemic sclerosis]], [[Erythema nodosum]], [[Psoriasis]]
|-
|-bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
|bgcolor="Beige"|  [[Acitretin]], [[Artemether/lumefantrine]], [[Asenapine maleate]], [[hyaluronic acid]], [[Bismuth]], [[Carbimazole]], [[Carfilzomib]], [[Cefadroxil]], [[Cidofovir]], [[Clomifene]], [[Ciprofloxacin]], [[caspofungin acetate]], [[Cefaclor]], [[Cyanocobalamin]], [[Deferiprone]], [[Efavirenz]], [[Enzalutamide]],[[Eliglustat]], [[eribulin]], [[Ethambutol]], [[Exemestane]], [[Fluorosis]], [[galsulfase]], [[Goserelin]], [[Gemifloxacin mesylate]], [[Idursulfase]], [[Indinavir]], [[Interferon gamma]], [[Isotretinoin]], [[Ivacaftor]], [[Ixabepilone]], [[Letrozole]], [[Methimazole]],[[Mianserin]], [[Mifepristone]], [[Minocycline hydrochloride]], [[mirtazapine]], [[Nabilone]], [[Natalizumab]], [[nefazodone]], [[Nalidixic acid]], [[Nateglinide]], [[Norfloxacin]], [[Omalizumab]], [[Paclitaxel]], [[Pantoprazole]],  [[Pentamidine Isethionate]], [[Pergolide]], [[Pertuzumab]], [[Pirfenidone]], [[Plerixafor]], [[Propylthiouracil]], [[Pyrazinamide]], [[Potassium iodide]], [[Quinupristin dalfopristin]], [[Rasagiline]], [[Rifaximin]], [[Ropinirole]], [[Riluzole]], [[Romiplostim]], [[Sargramostim]], [[Sertraline]], [[Siltuximab]], [[Sorafenib]], [[Sulfasalazine]], [[Sunitinib]], [[Tiagabine]], [[Tenofovir]], [[Teriparatide]], [[Trastuzumab]], [[Valacyclovir]], [[Vilazodone]], [[Zanamivir]], [[Zotepine]], [[Zonisamide]]
|-
|-bgcolor="LightSteelBlue"
| '''Ear Nose Throat'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Endocrine'''
|bgcolor="Beige"|[[Acromegaly]], [[Obesity]], [[Avascular necrosis]], [[Secondary hyperparathyroidism]]
|-
|-bgcolor="LightSteelBlue"
| '''Environmental'''
|bgcolor="Beige"|[[Metal fume fever]], [[pneumoconiosis]]
|-
|-bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
|bgcolor="Beige"|  [[Coeliac disease]], [[Crohn's disease]], [[Hepatitis]] A, B, C, [[Ulcerative Colitis]], [[Whipple disease]], [[Wilson's disease]], [[Autoimmune Hepatitis]], [[Celiac Sprue]]
|-
|-bgcolor="LightSteelBlue"
| '''Genetic'''
|bgcolor="Beige"| [[Ankylosing spondylitis]], [[Celiac Sprue]], [[Gaucher's disease]], [[Hereditary multiple exostoses]], Legg-Calve-Perthes syndrome, [[Limb-girdle muscular dystrophy]], [[Marfan syndrome]], [[Noonan's Syndrome]], [[Recessive Multiple Epiphyseal Dysplasia]], [[Muscular dystrophy]] 
|-
|-bgcolor="LightSteelBlue"
| '''Hematologic'''
|bgcolor="Beige"|  [[Haemochromatosis]], [[Haemophilia type A]], [[Henoch-Schönlein purpura]], [[Acute myeloid leukemia]], [[Acute promyelocytic leukemia]], [[Leukemia]], [[Thrombotic thrombocytopenic purpura]]
|-
|-bgcolor="LightSteelBlue"
| '''Iatrogenic'''
|bgcolor="Beige"| *[[Arthrofibrosis]]
|-
|-bgcolor="LightSteelBlue"
| '''Infectious Disease'''
|bgcolor="Beige"|  [[Atypical pneumonia]], [[Borrelia burgdorferi]], [[Lyme Disease]],  [[Chikungunya virus]], [[Coccidioidomycosis]] lung infection, [[Community-acquired pneumonia]]
[[Hepatitis]] A; B; C, [[Lepromatous leprosy]], [[Lyme disease]], [[Malaria]], Mayaro virus fever, [[Mycoplasma pneumoniae]], O'nyong-nyong fever, [[Parvovirus B19]] infection, [[Pharyngitis]], [[Rat bite fever]], [[Rheumatic Fever]], [[Ross River virus]], [[Rubella]], [[syphilis]], Semliki forest fever, [[Serum sickness]], [[Toxic shock syndrome]], [[Trichinosis]], [[West Nile fever]], [[Whipple disease]],[[Barmah Forest virus]], [[Chlamydia trachomatis]], [[Dengue fever]], [[Ebola]], [[Gonorrhea]], [[Relapsing fever]], [[Rocky Mountain spotted fever]], [[Tuberculosis]], [[Tularemia]], [[Yellow fever]], [[Yersinia enterocolitica Infection]], [[Yersinia pseudotuberculosis]], [[Zika fever]]
|-
|-bgcolor="LightSteelBlue"
| '''Musculoskeletal / Ortho'''
|bgcolor="Beige"|  [[Blau syndrome]], [[Borrelia burgdorferi]], [[Fibromyalgia]], [[Gout]], congenital [[hip dysplasia]], [[Hypertrophic pulmonary osteoarthropathy]], Jacobs arthropathy-camptodactyly syndrome, [[Juvenile idiopathic arthritis]], Lipoid dermatoarthritis, [[Lupus erythematosus]], [[Lyme disease]], [[Mixed connective tissue disease]],
Multiple epiphyseal dysplasia, [[Osteoarthritis]], [[Osteochondritis]] dissecans, [[Paget's disease of bone]], [[Palindromic rheumatism]], PAPA syndrome, [[Pigmented villonodular synovitis]], [[Polyarteritis nodosa]], [[Polychondritis]], Relapsing, Progressive pseudorheumatoid dysplasia, [[Pseudogout]], Recurrent hereditary [[polyserositis]], [[Rheumatoid arthritis]], [[Scleroderma]], Sclerosing [[osteomyelitis]] of Garre, [[Sjögren's syndrome]], [[Still's Disease]], [[Synovial chondromatosis]], [[Systemic sclerosis]], [[Takayasu's arteritis]], [[gout]],[[Adhesive capsulitis]] of shoulder, [[Ankylosing spondylitis]], [[Arthrofibrosis]], [[Avascular necrosis]], [[Baker's cyst]], [[Bursitis]],[[Erythema nodosum]], [[Marfan syndrome]], [[Osteoporosis]], [[Piriformis syndrome]], [[Plantar fasciitis]], [[Retropatellar Pain Syndrome]],[[Muscular dystrophy]], [[Scoliosis]], [[Slipped Upper Femoral Epiphysis]], [[Spondylitis]], [[Spondylolisthesis]], [[Spondylosis]],[[Subacromial bursitis]], [[Symphysis pubis dysfunction]], [[Tennis elbow]], [[Tenosynovitis]]
|-
|-bgcolor="LightSteelBlue"
| '''Neurologic'''
|bgcolor="Beige"| [[Neuropathic joint disease]], [[Poliomyelitis]]
|-
|-bgcolor="LightSteelBlue"
| '''Nutritional / Metabolic'''
|bgcolor="Beige"|  [[Obesity]]
|-
|-bgcolor="LightSteelBlue"
| '''Obstetric/Gynecologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Oncologic'''
|bgcolor="Beige"| [[Acute lymphoblastic leukemia]], [[Multiple myeloma]], [[Pigmented villonodular synovitis]], [[Acute myeloid leukemia]], [[Acute promyelocytic leukemia]], [[Giant cell tumor of bone]], [[Hereditary multiple exostoses]], [[Hurler syndrome]], [[Leukemia]], [[Soft tissue sarcoma]] 
|-
|-bgcolor="LightSteelBlue"
| '''Ophthalmologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Overdose / Toxicity'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Psychiatric'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Pulmonary'''
|bgcolor="Beige"| [[Atypical pneumonia]], [[Caplan's disease]], [[Coccidioidomycosis]] lung infection, [[Community-acquired pneumonia]],[[Mycoplasma pneumoniae]], [[pneumoconiosis]]
|-
|-bgcolor="LightSteelBlue"
| '''Renal / Electrolyte'''
|bgcolor="Beige"| [[Renal osteodystrophy]]
|-
|-bgcolor="LightSteelBlue"
| '''Rheum / Immune / Allergy'''
|bgcolor="Beige"|[[Behcet's disease]], [[Caplan's disease]], [[Coeliac disease]],  [[Crohn's disease]], [[Dressler's syndrome]], [[Erythema elevatum diutinum]], [[Hypothyroidism]],
Juvenile chronic arthritis, [[Lupus erythematosus]], [[Mixed connective tissue disease]], [[Polyarteritis nodosa]], [[Polychondritis]], Relapsing  [[Pyoderma gangrenosum]], [[Rheumatic Fever]], [[Rheumatoid arthritis]], [[Sarcoidosis]], [[Scleroderma]] , [[Serum sickness]],[[Sjögren's syndrome]], [[Still's Disease]], [[Systemic sclerosis]], [[Takayasu's arteritis]], [[Takayasu's arteritis]], [[Wegener's granulomatosis]], [[Ankylosing spondylitis]], [[Autoimmune Hepatitis]], [[Celiac Sprue]], [[Erythema nodosum]], [[Familial Mediterranean fever]], [[Iliotibial band syndrome]]
|-
|-bgcolor="LightSteelBlue"
| '''Sexual'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Trauma'''
|bgcolor="Beige"| [[Bursitis]], [[Complex regional pain syndrome]], [[Diastasis symphysis pubis]], [[Golfer's elbow]], [[Slipped Upper Femoral Epiphysis]], [[Tennis elbow]]
|-
|-bgcolor="LightSteelBlue"
| '''Urologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Miscellaneous'''
|bgcolor="Beige"| [[Complex regional pain syndrome]], [[Familial Mediterranean fever]], [[Kikuchi disease]]
|-
|}


===Complete Differential Diagnosis of the Causes of Arthralgia===
===Causes in Alphabetical Order<ref>Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016</ref><ref>Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X</ref>===
(In alphabetical order)
{{MultiCol}}
*[[Acitretin]]
*[[Acute lymphoblastic leukemia]]  
*[[Acute lymphoblastic leukemia]]  
*[[Acromegaly]]
*[[Acromegaly]]
Line 69: Line 158:
*[[Ankylosing spondylitis]]
*[[Ankylosing spondylitis]]
*[[Arthrofibrosis]]
*[[Arthrofibrosis]]
*[[Artemether/lumefantrine]]
*[[Atypical pneumonia]]
*[[Atypical pneumonia]]
*[[Autoimmune Hepatitis]]
*[[Autoimmune Hepatitis]]
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*[[Borrelia burgdorferi]] ([[Lyme Disease]])
*[[Borrelia burgdorferi]] ([[Lyme Disease]])
*[[Bruton's agammaglobulinemia]]
*[[Bruton's agammaglobulinemia]]
*[[Buprenorphine]]/[[Naloxone]]
*[[Bursitis]]
*[[Bursitis]]
*[[Caplan's disease]] ([[rheumatoid arthritis]] and [[pneumoconiosis]])  
*[[Caplan's disease]] ([[rheumatoid arthritis]] and [[pneumoconiosis]])  
*[[Carbimazole]]
*[[Carbimazole]]
*[[Cefadroxil]]
*[[Celiac Sprue]]
*[[Celiac Sprue]]
*[[Chikungunya virus]]
*[[Chikungunya virus]]
*[[Chlamydia trachomatis]]
*[[Chlamydia trachomatis]]
*[[Chronic fatigue syndrome]]
*[[Chronic fatigue syndrome]]
*[[Cidofovir]]
*[[Ciprofloxacin]] ([[Quinolone]]-induced cartilage toxicity in children)
*[[Ciprofloxacin]] ([[Quinolone]]-induced cartilage toxicity in children)
*[[Coccidioidomycosis]] lung infection
*[[Coccidioidomycosis]] lung infection
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*[[Crohn's disease]]
*[[Crohn's disease]]
*[[Cryoglobulinaemia]]
*[[Cryoglobulinaemia]]
*[[Cyanocobalamin]]
*[[Decompression sickness]]
*[[Decompression sickness]]
*[[Deferiprone]]
*[[Deferiprone]]
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*[[Dressler's syndrome]]
*[[Dressler's syndrome]]
*[[Ebola]]
*[[Ebola]]
*[[Efavirenz]]
*[[Ehlers-Danlos syndrome]]  
*[[Ehlers-Danlos syndrome]]  
*[[Emtricitabine]]
*[[Eribulin]]
*[[Erythema nodosum]]
*[[Erythema nodosum]]
*[[Erythema elevatum diutinum]] (is a rare type of [[leukocytoclastic vasculitis]] characterized by red, purple, brown, or yellow [[papule]]s, [[plaque]]s, or [[nodule]]s)
*[[Erythema elevatum diutinum]] (is a rare type of [[leukocytoclastic vasculitis]] characterized by red, purple, brown, or yellow [[papule]]s, [[plaque]]s, or [[nodule]]s)
*[[Exemestane]]
*[[Familial Mediterranean fever]]
*[[Familial Mediterranean fever]]
*[[Farber's disease]]
*[[Farber's disease]]
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*[[Hereditary multiple exostoses]]
*[[Hereditary multiple exostoses]]
*[[Hip dysplasia]], congenital
*[[Hip dysplasia]], congenital
*[[HPV Vaccine]] ([[Gardasil]])
*[[Hurler syndrome]]
*[[Hurler syndrome]]
*[[Hyperimmunoglobulinemia D]] and [[periodic fever syndrome]] ( attacks of [[fever]], arthralgia, [[skin lesion]]s, and [[diarrhea]])
*[[Hyperimmunoglobulinemia D]] and [[periodic fever syndrome]] ( attacks of [[fever]], arthralgia, [[skin lesion]]s, and [[diarrhea]])
Line 127: Line 227:
*[[Hypothyroidism]]
*[[Hypothyroidism]]
*[[Iliotibial band syndrome]]
*[[Iliotibial band syndrome]]
*[[Indinavir]]
*[[Infliximab]]
*[[Interferon gamma]]
*[[Interstitial nephritis]]
*[[Interstitial nephritis]]
*[[Ivacaftor]]
*[[Isotretinoin]]
*[[Isotretinoin]]
*[[Ixabepilone]]
*Jacobs arthropathy-camptodactyly syndrome
*Jacobs arthropathy-camptodactyly syndrome
*[[Janumet]] ([[sitagliptin]] and [[metformin]])
*[[Juvenile chronic arthritis]]
*[[Juvenile chronic arthritis]]
*[[Kawasaki disease]]
*[[Kawasaki disease]]
Line 148: Line 254:
*[[Methimazole]]
*[[Methimazole]]
*[[Mianserin]] ([[antidepressant]], also [[mirtazapine]] and [[nefazodone]] are associated with arthralgia)
*[[Mianserin]] ([[antidepressant]], also [[mirtazapine]] and [[nefazodone]] are associated with arthralgia)
*[[Mifepristone]]
*[[Mixed connective tissue disease]]
*[[Mixed connective tissue disease]]
*[[Morphoea]]/[[scleroderma]]
*[[Morphoea]]/[[scleroderma]]
*Multiple epiphyseal dysplasia: [[Recessive Multiple Epiphyseal Dysplasia]]
{{ColBreak}}
*Multiple epiphyseal dysplasia: Recessive multiple epiphyseal dysplasia
*[[Multiple myeloma]]
*[[Multiple myeloma]]
*[[Muscular dystrophy]]  
*[[Muscular dystrophy]]  
*[[Mycoplasma pneumoniae]]
*[[Mycoplasma pneumoniae]]
*[[Nabilone]]
*[[Nalidixic acid]]
*[[Nalidixic acid]]
*[[Natalizumab]]
*[[Nateglinide]]
*[[Nateglinide]]
*[[Neuropathic joint disease]]
*[[Neuropathic joint disease]]
Line 165: Line 275:
*[[Osteoporosis]]
*[[Osteoporosis]]
*Otospondylomegaepiphyseal dysplasia
*Otospondylomegaepiphyseal dysplasia
*[[Paclitaxel]]
*[[Paget's disease of bone]]
*[[Paget's disease of bone]]
*[[Palindromic rheumatism]] (idiopathic, periodic arthritis marked by multiple and recurrent attacks affecting one to a few joints, with tissue inflammation around or adjacent to them)
*[[Palindromic rheumatism]] (idiopathic, periodic arthritis marked by multiple and recurrent attacks affecting one to a few joints, with tissue inflammation around or adjacent to them)
*[[Pantoprazole]]
*PAPA syndrome ( Pyogenic arthritis, pyoderma gangrenosum and acne (PAPA) syndrome)
*PAPA syndrome ( Pyogenic arthritis, pyoderma gangrenosum and acne (PAPA) syndrome)
*[[Parvovirus B19]] infection
*[[Parvovirus B19]] infection
*[[Pergolide]]
*[[Pharyngitis]]
*[[Pharyngitis]]
*[[Pigmented villonodular synovitis]]
*[[Pigmented villonodular synovitis]]
*[[Pituitary tumour]] (*[[Acromegaly]], growth hormone secreting tumor)
*[[Pituitary tumour]] (*[[Acromegaly]], growth hormone secreting tumor)
*[[Pirfenidone]]
*[[Piriformis syndrome]]
*[[Piriformis syndrome]]
*[[Plantar fasciitis]]
*[[Plantar fasciitis]]
*[[Plerixafor]]
*[[pneumoconiosis]]
*[[pneumoconiosis]]
*[[Poliomyelitis]]
*[[Poliomyelitis]]
Line 186: Line 301:
*[[Rat bite fever]] (Streptobacillus moniliformis or Spirillum minus)
*[[Rat bite fever]] (Streptobacillus moniliformis or Spirillum minus)
*[[Reactive arthritis]]
*[[Reactive arthritis]]
*[[Recessive Multiple Epiphyseal Dysplasia]]
*Recessive multiple epiphyseal dysplasia
*Recurrent hereditary polyserositis
*Recurrent hereditary polyserositis
*[[Relapsing fever]]
*[[Relapsing fever]]
Line 200: Line 315:
*[[Scoliosis]]
*[[Scoliosis]]
*[[Secondary hyperparathyroidism]]
*[[Secondary hyperparathyroidism]]
*[[Semliki forest fever]]
*Sclerosing [[osteomyelitis]] of Garre
*Sclerosing [[osteomyelitis]] of Garre
*Secondary [[syphilis]]
*Secondary [[syphilis]]
Line 206: Line 320:
*[[Serum sickness]]
*[[Serum sickness]]
*[[Sickle cell disease]]
*[[Sickle cell disease]]
*[[Siltuximab]]
*[[Sjögren's syndrome]]
*[[Sjögren's syndrome]]
*[[Slipped Upper Femoral Epiphysis]]
*[[Slipped Upper Femoral Epiphysis]]
*[[Soft tissue sarcoma]]
*[[Soft tissue sarcoma]]
*[[Sorafenib]]
*[[Spondylitis]]
*[[Spondylitis]]
*[[Spondylolisthesis]]
*[[Spondylolisthesis]]
Line 215: Line 331:
*[[Still's Disease]], Juvenile-Onset
*[[Still's Disease]], Juvenile-Onset
*[[Subacromial bursitis]]
*[[Subacromial bursitis]]
*[[Sunitinib]]
*[[Sweet's disease]]
*[[Sweet's disease]]
*[[Symphysis pubis dysfunction]]
*[[Symphysis pubis dysfunction]]
Line 221: Line 338:
*[[Takayasu's arteritis]]  
*[[Takayasu's arteritis]]  
*[[Tennis elbow]]
*[[Tennis elbow]]
*[[Tenofovir]] disoproxil fumarate
*[[Tenosynovitis]]
*[[Tenosynovitis]]
*[[Teriparatide]]
*[[Tiagabine]]
*[[Thrombotic thrombocytopenic purpura]]
*[[Thrombotic thrombocytopenic purpura]]
*[[Toxic shock syndrome]]
*[[Toxic shock syndrome]]
Line 230: Line 350:
*[[Ulcerative Colitis]]  
*[[Ulcerative Colitis]]  
*Urate crystal arthropathy ([[gout]])
*Urate crystal arthropathy ([[gout]])
*[[Vilazodone]]
*[[Waldenström macroglobulinemia]]  
*[[Waldenström macroglobulinemia]]  
*[[Wegener's granulomatosis]]
*[[Wegener's granulomatosis]]
Line 239: Line 360:
*[[Yersinia enterocolitica Infection]] (Yersiniosis)
*[[Yersinia enterocolitica Infection]] (Yersiniosis)
*[[Yersinia pseudotuberculosis]]
*[[Yersinia pseudotuberculosis]]
*[[Zanamivir]]
*[[Zika fever]]
*[[Zika fever]]
*[[Zotepine]]
*[[Zotepine]]
{{EndMultiCol}}
==Diagnosis==
===History and Symptoms===
Diagnosis involves interviewing the patient and performing physical exams. When attempting to establish the cause of the arthralgia, the emphasis is on the interview.<ref name="jgh_arthralgia"/>  The patient is asked questions intended to narrow the number of potential causes. Given the varied nature of these possible causes, the questions may strike the uninitiated as irrelevant.  For example the patient may be asked about [[dry mouth]], [[light sensitivity]], [[rash]]es or a history of [[seizure]]s.<ref name="jgh_arthralgia"/>  <ref name="spondyl_table1" > {{cite web |url=http://www.ncbi.nlm.nih.gov/books/bv.fcgi?highlight=arthralgia&rid=cm.chapter.5910#5949
|title=  Table 159.3.  Selected Symptomatic Extraarticular Features of the Connective Tissue Diseases and the Spondyloarthropathies
|accessdate=2007-09-20
|format= HTML
|work=Clinical Methods - The History, Physical, and Laboratory Examinations  }}</ref>
Answering yes or no to any of these questions limits the number of possible causes and guides the doctor toward the appropriate exams and lab tests.
==Treatment==
===Medical Therapy===


===Complete Differential Diagnosis of the Causes of Arthralgia===
(By organ system)
{|style="width:80%; height:100px" border="1"
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" |  [[Dressler's syndrome]]
|-
|-bgcolor="LightSteelBlue"
| '''Chemical / poisoning'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Dermatologic'''
|bgcolor="Beige"|[[Blau syndrome]], [[Ehlers-Danlos syndrome]], [[Erythema elevatum diutinum]], [[Lepromatous leprosy]], [[Lipoid dermatoarthritis]], [[Lupus erythematosus]], [[Lyme disease]]
[[Mixed connective tissue disease]], [[scleroderma]], PAPA syndrome, [[Pyoderma gangrenosum]], [[Rheumatic Fever]], [[Scleroderma]], [[syphilis]], [[Sweet's disease]], [[Systemic sclerosis]], [[Erythema nodosum]], [[Psoriasis]]
|-
|-bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
|bgcolor="Beige"|  [[Bismuth]], [[Carbimazole]], [[Ciprofloxacin]], [[Deferiprone]],  [[Fluorosis]], [[Isotretinoin]], [[Methimazole]], [[Mianserin]], [[mirtazapine]], [[nefazodone]], [[Nalidixic acid]], [[Nateglinide]], [[Norfloxacin]], [[Propylthiouracil]], [[Pyrazinamide]], [[Trastuzumab]], [[Zotepine]], [[Avascular necrosis]]
|-
|-bgcolor="LightSteelBlue"
| '''Ear Nose Throat'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Endocrine'''
|bgcolor="Beige"|[[Acromegaly]], [[Obesity]], [[Avascular necrosis]], [[Secondary hyperparathyroidism]]
|-
|-bgcolor="LightSteelBlue"
| '''Environmental'''
|bgcolor="Beige"|[[Metal fume fever]], [[pneumoconiosis]]
|-
|-bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
|bgcolor="Beige"|  [[Coeliac disease]], [[Crohn's disease]], [[Hepatitis]] A, B, C, [[Ulcerative Colitis]], [[Whipple disease]], [[Wilson's disease]], [[Autoimmune Hepatitis]], [[Celiac Sprue]]
|-
|-bgcolor="LightSteelBlue"
| '''Genetic'''
|bgcolor="Beige"| [[Ankylosing spondylitis]], [[Celiac Sprue]], [[Gaucher's disease]], [[Hereditary multiple exostoses]], Legg-Calve-Perthes syndrome, [[Limb-girdle muscular dystrophy]], [[Marfan syndrome]], [[Noonan's Syndrome]], [[Recessive Multiple Epiphyseal Dysplasia]], [[Muscular dystrophy]] 
|-
|-bgcolor="LightSteelBlue"
| '''Hematologic'''
|bgcolor="Beige"|  [[Haemochromatosis]], [[Haemophilia type A]], [[Henoch-Schönlein purpura]], [[Acute myeloid leukemia]], [[Acute promyelocytic leukemia]], [[Leukemia]], [[Thrombotic thrombocytopenic purpura]]
|-
|-bgcolor="LightSteelBlue"
| '''Iatrogenic'''
|bgcolor="Beige"| *[[Arthrofibrosis]],
|-
|-bgcolor="LightSteelBlue"
| '''Infectious Disease'''
|bgcolor="Beige"|  [[Atypical pneumonia]], [[Borrelia burgdorferi]], [[Lyme Disease]],  [[Chikungunya virus]], [[Coccidioidomycosis]] lung infection, [[Community-acquired pneumonia]]
[[Hepatitis]] A; B; C, [[Lepromatous leprosy]], [[Lyme disease]], [[Malaria]], Mayaro virus fever, [[Mycoplasma pneumoniae]], O'nyong-nyong fever, [[Parvovirus B19]] infection,  [[Pharyngitis]], [[Rat bite fever]], [[Rheumatic Fever]], [[Ross River virus]], [[Rubella]],
[[syphilis]], Semliki forest fever, [[Serum sickness]], [[Toxic shock syndrome]], [[Trichinosis]], [[West Nile fever]], [[Whipple disease]], [[Barmah Forest virus]], [[Chlamydia trachomatis]], [[Dengue fever]], [[Ebola]], [[Gonorrhea]], [[Relapsing fever]], [[Rocky Mountain spotted fever]], [[Tuberculosis]], [[Tularemia]], [[Yellow fever]], [[Yersinia enterocolitica Infection]], [[Yersinia pseudotuberculosis]], [[Zika fever]]
|-
|-bgcolor="LightSteelBlue"
| '''Musculoskeletal / Ortho'''
|bgcolor="Beige"|  [[Blau syndrome]], [[Borrelia burgdorferi]], [[Fibromyalgia]], [[Gout]],
congenital [[Hip dysplasia]], [[Hypertrophic pulmonary osteoarthropathy]], Jacobs arthropathy-camptodactyly syndrome, [[Juvenile idiopathic arthritis]], Lipoid dermatoarthritis, [[Lupus erythematosus]], [[Lyme disease]], [[Mixed connective tissue disease]],
Multiple epiphyseal dysplasia, [[Osteoarthritis]], [[Osteochondritis]] dissecans, [[Paget's disease of bone]], [[Palindromic rheumatism]], PAPA syndrome, [[Pigmented villonodular synovitis]], [[Polyarteritis nodosa]], [[Polychondritis]], Relapsing, Progressive pseudorheumatoid dysplasia, [[Pseudogout]], Recurrent hereditary [[polyserositis]], [[Rheumatoid arthritis]], [[Scleroderma]], Sclerosing [[osteomyelitis]] of Garre, [[Sjögren's syndrome]],  [[Still's Disease]], [[Synovial chondromatosis]], [[Systemic sclerosis]], [[Takayasu's arteritis]], [[gout]], [[Adhesive capsulitis]] of shoulder, [[Ankylosing spondylitis]], [[Arthrofibrosis]], [[Avascular necrosis]], [[Baker's cyst]], [[Bursitis]], [[Erythema nodosum]], [[Marfan syndrome]], [[Osteoporosis]], [[Piriformis syndrome]], [[Plantar fasciitis]], [[Retropatellar Pain Syndrome]], [[Muscular dystrophy]], [[Scoliosis]], [[Slipped Upper Femoral Epiphysis]], [[Spondylitis]], [[Spondylolisthesis]], [[Spondylosis]], [[Subacromial bursitis]], [[Symphysis pubis dysfunction]], [[Tennis elbow]], [[Tenosynovitis]]
|-
|-bgcolor="LightSteelBlue"
| '''Neurologic'''
|bgcolor="Beige"| [[Neuropathic joint disease]], [[Poliomyelitis]]
|-
|-bgcolor="LightSteelBlue"
| '''Nutritional / Metabolic'''
|bgcolor="Beige"|  [[Obesity]]
|-
|-bgcolor="LightSteelBlue"
| '''Obstetric/Gynecologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Oncologic'''
|bgcolor="Beige"| [[Acute lymphoblastic leukemia]], [[Multiple myeloma]], [[Pigmented villonodular synovitis]], [[Acute myeloid leukemia]], [[Acute promyelocytic leukemia]], [[Giant cell tumor of bone]], [[Hereditary multiple exostoses]], [[Hurler syndrome]], [[Leukemia]], [[Soft tissue sarcoma]] 
|-
|-bgcolor="LightSteelBlue"
| '''Opthalmologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Overdose / Toxicity'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Psychiatric'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Pulmonary'''
|bgcolor="Beige"|  [[Atypical pneumonia]], [[Caplan's disease]], [[Coccidioidomycosis]] lung infection, [[Community-acquired pneumonia]], [[Mycoplasma pneumoniae]], [[pneumoconiosis]]
|-
|-bgcolor="LightSteelBlue"
| '''Renal / Electrolyte'''
|bgcolor="Beige"|[[Renal osteodystrophy]]
|-
|-bgcolor="LightSteelBlue"
| '''Rheum / Immune / Allergy'''
|bgcolor="Beige"|"|[[Behcet's disease]], [[Caplan's disease]], [[Coeliac disease]],  [[Crohn's disease]], [[Dressler's syndrome]], [[Erythema elevatum diutinum]], [[Hypothyroidism]],
Juvenile chronic arthritis, [[Lupus erythematosus]], [[Mixed connective tissue disease]], [[Polyarteritis nodosa]], [[Polychondritis]], Relapsing  [[Pyoderma gangrenosum]], [[Rheumatic Fever]], [[Rheumatoid arthritis]], [[Sarcoidosis]], [[Scleroderma]] , [[Serum sickness]], [[Sjögren's syndrome]], [[Still's Disease]], [[Systemic sclerosis]], [[Takayasu's arteritis]], [[Takayasu's arteritis]], [[Wegener's granulomatosis]], [[Ankylosing spondylitis]], [[Autoimmune Hepatitis]], [[Celiac Sprue]], [[Erythema nodosum]], [[Familial Mediterranean fever]], [[Iliotibial band syndrome]]
|-
|-bgcolor="LightSteelBlue"
| '''Sexual'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Trauma'''
|bgcolor="Beige"| [[Bursitis]], [[Complex regional pain syndrome]], [[Diastasis symphysis pubis]], [[Golfer's elbow]], [[Slipped Upper Femoral Epiphysis]], [[Tennis elbow]]
|-
|-bgcolor="LightSteelBlue"
| '''Urologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Miscellaneous'''
|bgcolor="Beige"| [[Complex regional pain syndrome]], [[Familial Mediterranean fever]], [[Kikuchi disease]]
|-
|}


Treatment depends on specific underlying cause. The underlying cause will be treated first and foremost. The treatments may include [[immunosuppressant]]s for [[immune system]] dysfunction, [[antibiotic]]s when an [[infection]] is the cause, and discontinuing medication when an allergic reaction is the cause. When treating the primary cause, pain management may still play a role in treatment. The extent of its role varies depending on the specific cause of the arthralgia. Pain management may include stretching exercises, over the counter pain medications, prescription [[pain]] medication, or other treatments deemed appropriate for the symptoms.


<ref>Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016</ref> <ref>Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X</ref>
===Surgery===
Joint replacement surgery is done for severely damaged [[joint]]s.


==See also==
==References==
==References==
{{reflist|2}}
{{reflist|2}}
==External links==


{{Diseases of the musculoskeletal system and connective tissue}}
{{Diseases of the musculoskeletal system and connective tissue}}
{{SIB}}


[[de:Arthralgie]]
[[de:Arthralgie]]
[[fr:Arthralgie]]
[[fr:Arthralgie]]
[[pl:Artralgia]]


{{WH}}
{{WS}}


[[Category:Rheumatology]]
[[Category:Rheumatology]]
[[Category:Symptoms]]
[[Category:Signs and symptoms]]
[[Category:Signs and symptoms]]
[[pl:Artralgia]]
{{WH}}
{{WS}}

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohammadmain Rezazadehsaatlou[2].

Overview

Arthralgia (from Greek arthro-, joint + -algos, pain) literally means joint pain; [1][2] it is a symptom of injury, infection, illnesses in particular arthritis or an allergic reaction to medication.[3] According to MeSH, the term arthralgia should only be used when the condition is non-inflammatory, and the term arthritis should be used when the condition is inflammatory.[4]

Causes

The causes of arthralgia are varied and range from, a joints perspective, degenerative and destructive processes such as osteoarthritis and sports injuries to inflammation of tissues surrounding the joints (e.g. bursitis, a painful inflammation of bursa, fluid filled sacks around the joints). [5]

Common Causes

Causes by Organ System

Cardiovascular Dressler's syndrome
Chemical / poisoning No underlying causes
Dermatologic Blau syndrome, Ehlers-Danlos syndrome, Erythema elevatum diutinum, Lepromatous leprosy, Lipoid dermatoarthritis, Lupus erythematosus, Lyme disease, Mixed connective tissue disease, scleroderma, PAPA syndrome, Pyoderma gangrenosum, Rheumatic Fever, Scleroderma,syphilis, Sweet's disease, Systemic sclerosis, Erythema nodosum, Psoriasis
Drug Side Effect Acitretin, Artemether/lumefantrine, Asenapine maleate, hyaluronic acid, Bismuth, Carbimazole, Carfilzomib, Cefadroxil, Cidofovir, Clomifene, Ciprofloxacin, caspofungin acetate, Cefaclor, Cyanocobalamin, Deferiprone, Efavirenz, Enzalutamide,Eliglustat, eribulin, Ethambutol, Exemestane, Fluorosis, galsulfase, Goserelin, Gemifloxacin mesylate, Idursulfase, Indinavir, Interferon gamma, Isotretinoin, Ivacaftor, Ixabepilone, Letrozole, Methimazole,Mianserin, Mifepristone, Minocycline hydrochloride, mirtazapine, Nabilone, Natalizumab, nefazodone, Nalidixic acid, Nateglinide, Norfloxacin, Omalizumab, Paclitaxel, Pantoprazole, Pentamidine Isethionate, Pergolide, Pertuzumab, Pirfenidone, Plerixafor, Propylthiouracil, Pyrazinamide, Potassium iodide, Quinupristin dalfopristin, Rasagiline, Rifaximin, Ropinirole, Riluzole, Romiplostim, Sargramostim, Sertraline, Siltuximab, Sorafenib, Sulfasalazine, Sunitinib, Tiagabine, Tenofovir, Teriparatide, Trastuzumab, Valacyclovir, Vilazodone, Zanamivir, Zotepine, Zonisamide
Ear Nose Throat No underlying causes
Endocrine Acromegaly, Obesity, Avascular necrosis, Secondary hyperparathyroidism
Environmental Metal fume fever, pneumoconiosis
Gastroenterologic Coeliac disease, Crohn's disease, Hepatitis A, B, C, Ulcerative Colitis, Whipple disease, Wilson's disease, Autoimmune Hepatitis, Celiac Sprue
Genetic Ankylosing spondylitis, Celiac Sprue, Gaucher's disease, Hereditary multiple exostoses, Legg-Calve-Perthes syndrome, Limb-girdle muscular dystrophy, Marfan syndrome, Noonan's Syndrome, Recessive Multiple Epiphyseal Dysplasia, Muscular dystrophy
Hematologic Haemochromatosis, Haemophilia type A, Henoch-Schönlein purpura, Acute myeloid leukemia, Acute promyelocytic leukemia, Leukemia, Thrombotic thrombocytopenic purpura
Iatrogenic *Arthrofibrosis
Infectious Disease Atypical pneumonia, Borrelia burgdorferi, Lyme Disease, Chikungunya virus, Coccidioidomycosis lung infection, Community-acquired pneumonia

Hepatitis A; B; C, Lepromatous leprosy, Lyme disease, Malaria, Mayaro virus fever, Mycoplasma pneumoniae, O'nyong-nyong fever, Parvovirus B19 infection, Pharyngitis, Rat bite fever, Rheumatic Fever, Ross River virus, Rubella, syphilis, Semliki forest fever, Serum sickness, Toxic shock syndrome, Trichinosis, West Nile fever, Whipple disease,Barmah Forest virus, Chlamydia trachomatis, Dengue fever, Ebola, Gonorrhea, Relapsing fever, Rocky Mountain spotted fever, Tuberculosis, Tularemia, Yellow fever, Yersinia enterocolitica Infection, Yersinia pseudotuberculosis, Zika fever

Musculoskeletal / Ortho Blau syndrome, Borrelia burgdorferi, Fibromyalgia, Gout, congenital hip dysplasia, Hypertrophic pulmonary osteoarthropathy, Jacobs arthropathy-camptodactyly syndrome, Juvenile idiopathic arthritis, Lipoid dermatoarthritis, Lupus erythematosus, Lyme disease, Mixed connective tissue disease,

Multiple epiphyseal dysplasia, Osteoarthritis, Osteochondritis dissecans, Paget's disease of bone, Palindromic rheumatism, PAPA syndrome, Pigmented villonodular synovitis, Polyarteritis nodosa, Polychondritis, Relapsing, Progressive pseudorheumatoid dysplasia, Pseudogout, Recurrent hereditary polyserositis, Rheumatoid arthritis, Scleroderma, Sclerosing osteomyelitis of Garre, Sjögren's syndrome, Still's Disease, Synovial chondromatosis, Systemic sclerosis, Takayasu's arteritis, gout,Adhesive capsulitis of shoulder, Ankylosing spondylitis, Arthrofibrosis, Avascular necrosis, Baker's cyst, Bursitis,Erythema nodosum, Marfan syndrome, Osteoporosis, Piriformis syndrome, Plantar fasciitis, Retropatellar Pain Syndrome,Muscular dystrophy, Scoliosis, Slipped Upper Femoral Epiphysis, Spondylitis, Spondylolisthesis, Spondylosis,Subacromial bursitis, Symphysis pubis dysfunction, Tennis elbow, Tenosynovitis

Neurologic Neuropathic joint disease, Poliomyelitis
Nutritional / Metabolic Obesity
Obstetric/Gynecologic No underlying causes
Oncologic Acute lymphoblastic leukemia, Multiple myeloma, Pigmented villonodular synovitis, Acute myeloid leukemia, Acute promyelocytic leukemia, Giant cell tumor of bone, Hereditary multiple exostoses, Hurler syndrome, Leukemia, Soft tissue sarcoma
Ophthalmologic No underlying causes
Overdose / Toxicity No underlying causes
Psychiatric No underlying causes
Pulmonary Atypical pneumonia, Caplan's disease, Coccidioidomycosis lung infection, Community-acquired pneumonia,Mycoplasma pneumoniae, pneumoconiosis
Renal / Electrolyte Renal osteodystrophy
Rheum / Immune / Allergy Behcet's disease, Caplan's disease, Coeliac disease, Crohn's disease, Dressler's syndrome, Erythema elevatum diutinum, Hypothyroidism,

Juvenile chronic arthritis, Lupus erythematosus, Mixed connective tissue disease, Polyarteritis nodosa, Polychondritis, Relapsing Pyoderma gangrenosum, Rheumatic Fever, Rheumatoid arthritis, Sarcoidosis, Scleroderma , Serum sickness,Sjögren's syndrome, Still's Disease, Systemic sclerosis, Takayasu's arteritis, Takayasu's arteritis, Wegener's granulomatosis, Ankylosing spondylitis, Autoimmune Hepatitis, Celiac Sprue, Erythema nodosum, Familial Mediterranean fever, Iliotibial band syndrome

Sexual No underlying causes
Trauma Bursitis, Complex regional pain syndrome, Diastasis symphysis pubis, Golfer's elbow, Slipped Upper Femoral Epiphysis, Tennis elbow
Urologic No underlying causes
Miscellaneous Complex regional pain syndrome, Familial Mediterranean fever, Kikuchi disease

Causes in Alphabetical Order[6][7]


Diagnosis

History and Symptoms

Diagnosis involves interviewing the patient and performing physical exams. When attempting to establish the cause of the arthralgia, the emphasis is on the interview.[2] The patient is asked questions intended to narrow the number of potential causes. Given the varied nature of these possible causes, the questions may strike the uninitiated as irrelevant. For example the patient may be asked about dry mouth, light sensitivity, rashes or a history of seizures.[2] [8] Answering yes or no to any of these questions limits the number of possible causes and guides the doctor toward the appropriate exams and lab tests.

Treatment

Medical Therapy

Treatment depends on specific underlying cause. The underlying cause will be treated first and foremost. The treatments may include immunosuppressants for immune system dysfunction, antibiotics when an infection is the cause, and discontinuing medication when an allergic reaction is the cause. When treating the primary cause, pain management may still play a role in treatment. The extent of its role varies depending on the specific cause of the arthralgia. Pain management may include stretching exercises, over the counter pain medications, prescription pain medication, or other treatments deemed appropriate for the symptoms.

Surgery

Joint replacement surgery is done for severely damaged joints.

References

  1. ↑ "Arthralgia Definition" (HTML). MedicineNet.com. Retrieved 2007-09-20.
  2. ↑ 2.0 2.1 2.2 Joe G. Hardin. "Arthralgia" (HTML). Clinical Methods - The History, Physical, and Laboratory Examinations. Retrieved 2007-09-20.
  3. ↑ James R Philp. "Allergic Drug Reactions - Systemic Allergic Drug Reactions" (HTML). Clinical Methods - The History, Physical, and Laboratory Examinations. Retrieved 2007-09-20.
  4. ↑ "MeSH". Retrieved 2007-12-23.
  5. ↑ Joe G. Hardin. "Table 161.1. Some Common Regional Rheumatic Syndromes" (HTML). Clinical Methods - The History, Physical, and Laboratory Examinations. Retrieved 2007-09-20.
  6. ↑ Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016
  7. ↑ Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X
  8. ↑ "Table 159.3. Selected Symptomatic Extraarticular Features of the Connective Tissue Diseases and the Spondyloarthropathies" (HTML). Clinical Methods - The History, Physical, and Laboratory Examinations. Retrieved 2007-09-20.

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