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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>
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==
==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  
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
Line 52: Line 45:
|format= HTML  
|format= HTML  
|work=Clinical Methods - The History, Physical, and Laboratory Examinations }}</ref>
|work=Clinical Methods - The History, Physical, and Laboratory Examinations }}</ref>
==Treatment==
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.


===Complete Differential Diagnosis of the Causes of Arthralgia===
===Complete Differential Diagnosis of the Causes of Arthralgia===
Line 359: Line 349:
<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>
<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>


==See also==
==Diagnosis==
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.
 
==Treatment==
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.
 
==References==
==References==
{{reflist|2}}
{{reflist|2}}
==External links==


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


[[de:Arthralgie]]
[[de:Arthralgie]]
[[fr:Arthralgie]]
[[fr:Arthralgie]]


[[Category:Rheumatology]]
[[Category:Rheumatology]]

Revision as of 12:22, 9 August 2012

Arthralgia
ICD-10 M25.5
ICD-9 719.4
DiseasesDB 15237
MeSH D018771

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: John Fani Srour, M.D.

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]

Complete Differential Diagnosis of the Causes of Arthralgia

(In alphabetical order)

Complete Differential Diagnosis of the Causes of Arthralgia

(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 Bismuth, Carbimazole, Ciprofloxacin, Deferiprone, Fluorosis, Isotretinoin, Methimazole, Mianserin, mirtazapine, nefazodone, Nalidixic acid, Nateglinide, Norfloxacin, Propylthiouracil, Pyrazinamide, Trastuzumab, Zotepine, Avascular necrosis
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
Opthalmologic 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


[6] [7]

Diagnosis

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

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.

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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