Joint pain: Clinical (To be retired)


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Joint pain: Clinical (To be retired)

Medicine and surgery

Allergy and immunology

Antihistamines for allergies


Cardiology, cardiac surgery and vascular surgery

Coronary artery disease: Clinical (To be retired)

Heart failure: Clinical (To be retired)

Syncope: Clinical (To be retired)

Hypertension: Clinical (To be retired)

Hypercholesterolemia: Clinical (To be retired)

Peripheral vascular disease: Clinical (To be retired)

Leg ulcers: Clinical (To be retired)

Adrenergic antagonists: Alpha blockers

Adrenergic antagonists: Beta blockers

ACE inhibitors, ARBs and direct renin inhibitors

Thiazide and thiazide-like diuretics

Calcium channel blockers

Lipid-lowering medications: Statins

Lipid-lowering medications: Fibrates

Miscellaneous lipid-lowering medications

Antiplatelet medications

Dermatology and plastic surgery

Hypersensitivity skin reactions: Clinical (To be retired)

Eczematous rashes: Clinical (To be retired)

Papulosquamous skin disorders: Clinical (To be retired)

Alopecia: Clinical (To be retired)

Hypopigmentation skin disorders: Clinical (To be retired)

Benign hyperpigmented skin lesions: Clinical (To be retired)

Skin cancer: Clinical (To be retired)

Endocrinology and ENT (Otolaryngology)

Diabetes mellitus: Clinical (To be retired)

Hyperthyroidism: Clinical (To be retired)

Hypothyroidism and thyroiditis: Clinical (To be retired)

Dizziness and vertigo: Clinical (To be retired)

Hyperthyroidism medications

Hypothyroidism medications


Hypoglycemics: Insulin secretagogues

Miscellaneous hypoglycemics

Gastroenterology and general surgery

Gastroesophageal reflux disease (GERD): Clinical (To be retired)

Peptic ulcers and stomach cancer: Clinical (To be retired)

Diarrhea: Clinical (To be retired)

Malabsorption: Clinical (To be retired)

Colorectal cancer: Clinical (To be retired)

Diverticular disease: Clinical (To be retired)

Anal conditions: Clinical (To be retired)

Cirrhosis: Clinical (To be retired)

Breast cancer: Clinical (To be retired)

Laxatives and cathartics


Acid reducing medications

Hematology and oncology

Anemia: Clinical (To be retired)

Anticoagulants: Warfarin

Anticoagulants: Direct factor inhibitors

Antiplatelet medications

Infectious diseases

Pneumonia: Clinical (To be retired)

Urinary tract infections: Clinical (To be retired)

Skin and soft tissue infections: Clinical (To be retired)

Protein synthesis inhibitors: Aminoglycosides

Antimetabolites: Sulfonamides and trimethoprim

Miscellaneous cell wall synthesis inhibitors

Protein synthesis inhibitors: Tetracyclines

Cell wall synthesis inhibitors: Penicillins

Miscellaneous protein synthesis inhibitors

Cell wall synthesis inhibitors: Cephalosporins

DNA synthesis inhibitors: Metronidazole

DNA synthesis inhibitors: Fluoroquinolones

Herpesvirus medications



Miscellaneous antifungal medications

Anti-mite and louse medications

Nephrology and urology

Chronic kidney disease: Clinical (To be retired)

Kidney stones: Clinical (To be retired)

Urinary incontinence: Pathology review

ACE inhibitors, ARBs and direct renin inhibitors

PDE5 inhibitors

Adrenergic antagonists: Alpha blockers

Neurology and neurosurgery

Stroke: Clinical (To be retired)

Lower back pain: Clinical (To be retired)

Headaches: Clinical (To be retired)

Migraine medications

Pulmonology and thoracic surgery

Asthma: Clinical (To be retired)

Chronic obstructive pulmonary disease (COPD): Clinical (To be retired)

Lung cancer: Clinical (To be retired)

Antihistamines for allergies

Bronchodilators: Beta 2-agonists and muscarinic antagonists

Bronchodilators: Leukotriene antagonists and methylxanthines

Pulmonary corticosteroids and mast cell inhibitors

Rheumatology and orthopedic surgery

Joint pain: Clinical (To be retired)

Rheumatoid arthritis: Clinical (To be retired)

Lower back pain: Clinical (To be retired)

Anatomy clinical correlates: Clavicle and shoulder

Anatomy clinical correlates: Arm, elbow and forearm

Anatomy clinical correlates: Wrist and hand

Anatomy clinical correlates: Median, ulnar and radial nerves

Anatomy clinical correlates: Bones, joints and muscles of the back

Anatomy clinical correlates: Hip, gluteal region and thigh

Anatomy clinical correlates: Knee

Anatomy clinical correlates: Leg and ankle

Anatomy clinical correlates: Foot

Acetaminophen (Paracetamol)

Non-steroidal anti-inflammatory drugs


Opioid agonists, mixed agonist-antagonists and partial agonists

Antigout medications

Osteoporosis medications


Joint pain: Clinical (To be retired)

USMLE® Step 2 questions

0 / 41 complete


USMLE® Step 2 style questions USMLE

of complete

A 68-year-old woman comes to her primary care physician for evaluation of left knee pain. The symptoms began about half-a-year ago. She works as a supermarket cashier and reports that the pain is worse in the evening. Past medical history is notable for hypertension and atherosclerosis. Temperature is 37.2°C (99.0°F), blood pressure is 137/85 mmHg, and body mass index is 30 kg/m2. Physical examination is notable for crepitus and reduced range of motion in the left knee. No erythema or warmth is noted at the affected joint. Cardiac, pulmonary, and abdominal examinations are noncontributory. Which of the following is the next best step in the management of this patient?  


Content Reviewers

Rishi Desai, MD, MPH

Joint pain is associated with a variety of disorders, so identifying the underlying cause can be hard.

First off, there’s the pain itself and there’s the underlying condition.

The underlying condition causing the joint pain which can either be acute or chronic.

In acute conditions, like a trauma, the joint pain develops right away, whereas in an infection or a bone or soft tissue malignancy the joint pain develop over days to weeks.

Alternatively, in chronic conditions like osteoarthritis, the joint pain happens over weeks to months, and in inflammatory conditions, that typically cause intermittent flares of joint pain, which are acute attacks, but the cause is still chronic.

The first step is to see how many joints are involved.

Generally speaking, joint pain can be monoarticular, meaning only one joint is involved, or polyarticular, meaning two or more joints are involved.

The major causes of monoarticular joint pain are trauma, infection, malignancy, and osteoarthritis.

The major causes of polyarticular joint pain are inflammatory autoimmune diseases, like lupus, as well as other systemic diseases like sarcoidosis.

Now, in the early stages and during flares, some inflammatory diseases can cause monoarticular pain.

So the next step is to figure out if the joint pain is inflammatory or non-inflammatory.

In non-inflammatory disease, the joint pain tends to be acute, worsen with movement and is relieved by rest.

On the other hand, in inflammatory diseases, symptoms tend to be more chronic, and worsen with immobility, leading to morning stiffness.

In addition, with inflammatory conditions, there’s usually swelling, loss of function, redness, and warmth.

Additionally, inflammatory conditions may cause an effusion or synovitis.

In contrast, in non-inflammatory conditions, there might be swelling and loss of function, but there’s usually no redness or warmth.

Finally, inflammatory diseases can cause a wide variety of extra-articular symptoms like fever, fatigue, skin rash, adenopathy, alopecia, oral and nasal ulcers, pleuritic chest pain, Raynaud phenomenon, or dry eyes and mouth.

If an inflammatory condition is suspected, then lab work can help confirm the diagnosis.

A complete blood count might show an increased white blood cell count, an elevated ESR and CRP, and specific antibodies might be elevated, for example, an ANA anti- double stranded DNA antibodies for lupus, rheumatoid factor and anti-citrullinated peptide antibodies for rheumatoid arthritis, anti- Ro and La antibodies for Sjogren’s syndrome, anti-centromere antibodies for scleroderma, and anti-topoisomerase antibodies for systemic sclerosis.


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