Joint pain: Clinical (To be retired)
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Joint pain: Clinical (To be retired)
Subspeciality surgery
Cardiothoracic surgery
Coronary artery disease: Clinical (To be retired)
Valvular heart disease: Clinical (To be retired)
Pericardial disease: Clinical (To be retired)
Aortic aneurysms and dissections: Clinical (To be retired)
Chest trauma: Clinical (To be retired)
Pleural effusion: Clinical (To be retired)
Pneumothorax: Clinical (To be retired)
Lung cancer: Clinical (To be retired)
Anatomy clinical correlates: Thoracic wall
Anatomy clinical correlates: Heart
Anatomy clinical correlates: Pleura and lungs
Anatomy clinical correlates: Mediastinum
Adrenergic antagonists: Beta blockers
ACE inhibitors, ARBs and direct renin inhibitors
cGMP mediated smooth muscle vasodilators
Lipid-lowering medications: Statins
Lipid-lowering medications: Fibrates
Miscellaneous lipid-lowering medications
Antiplatelet medications
Plastic surgery
Benign hyperpigmented skin lesions: Clinical (To be retired)
Skin cancer: Clinical (To be retired)
Blistering skin disorders: Clinical (To be retired)
Bites and stings: Clinical (To be retired)
Burns: Clinical (To be retired)
ENT (Otolaryngology)
Anatomy clinical correlates: Olfactory (CN I) and optic (CN II) nerves
Anatomy clinical correlates: Trigeminal nerve (CN V)
Anatomy clinical correlates: Facial (CN VII) and vestibulocochlear (CN VIII) nerves
Anatomy clinical correlates: Glossopharyngeal (CN IX), vagus (X), spinal accessory (CN XI) and hypoglossal (CN XII) nerves
Anatomy clinical correlates: Skull, face and scalp
Anatomy clinical correlates: Ear
Anatomy clinical correlates: Temporal regions, oral cavity and nose
Anatomy clinical correlates: Bones, fascia and muscles of the neck
Anatomy clinical correlates: Vessels, nerves and lymphatics of the neck
Anatomy clinical correlates: Viscera of the neck
Antihistamines for allergies
Neurosurgery
Stroke: Clinical (To be retired)
Seizures: Clinical (To be retired)
Headaches: Clinical (To be retired)
Traumatic brain injury: Clinical (To be retired)
Neck trauma: Clinical (To be retired)
Brain tumors: Clinical (To be retired)
Lower back pain: Clinical (To be retired)
Anatomy clinical correlates: Olfactory (CN I) and optic (CN II) nerves
Anatomy clinical correlates: Oculomotor (CN III), trochlear (CN IV) and abducens (CN VI) nerves
Anatomy clinical correlates: Trigeminal nerve (CN V)
Anatomy clinical correlates: Facial (CN VII) and vestibulocochlear (CN VIII) nerves
Anatomy clinical correlates: Glossopharyngeal (CN IX), vagus (X), spinal accessory (CN XI) and hypoglossal (CN XII) nerves
Anatomy clinical correlates: Vertebral canal
Anatomy clinical correlates: Spinal cord pathways
Anatomy clinical correlates: Cerebral hemispheres
Anatomy clinical correlates: Anterior blood supply to the brain
Anatomy clinical correlates: Cerebellum and brainstem
Anatomy clinical correlates: Posterior blood supply to the brain
Anticonvulsants and anxiolytics: Barbiturates
Anticonvulsants and anxiolytics: Benzodiazepines
Nonbenzodiazepine anticonvulsants
Migraine medications
Osmotic diuretics
Antiplatelet medications
Thrombolytics
Ophthalmology
Eye conditions: Refractive errors, lens disorders and glaucoma: Pathology review
Eye conditions: Retinal disorders: Pathology review
Eye conditions: Inflammation, infections and trauma: Pathology review
Anatomy clinical correlates: Olfactory (CN I) and optic (CN II) nerves
Anatomy clinical correlates: Oculomotor (CN III), trochlear (CN IV) and abducens (CN VI) nerves
Anatomy clinical correlates: Eye
Orthopedic surgery
Joint pain: Clinical (To be retired)
Lower back pain: Clinical (To be retired)
Anatomy clinical correlates: Clavicle and shoulder
Anatomy clinical correlates: Axilla
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
Trauma surgery
Traumatic brain injury: Clinical (To be retired)
Neck trauma: Clinical (To be retired)
Chest trauma: Clinical (To be retired)
Abdominal trauma: Clinical (To be retired)
Urology
Penile conditions: Pathology review
Prostate disorders and cancer: Pathology review
Testicular tumors: Pathology review
Kidney stones: Clinical (To be retired)
Renal cysts and cancer: Clinical (To be retired)
Urinary incontinence: Pathology review
Testicular and scrotal conditions: Pathology review
Anatomy clinical correlates: Male pelvis and perineum
Anatomy clinical correlates: Female pelvis and perineum
Anatomy clinical correlates: Other abdominal organs
Anatomy clinical correlates: Inguinal region
Androgens and antiandrogens
PDE5 inhibitors
Adrenergic antagonists: Alpha blockers
Vascular surgery
Peripheral vascular disease: Clinical (To be retired)
Leg ulcers: Clinical (To be retired)
Aortic aneurysms and dissections: Clinical (To be retired)
Anatomy clinical correlates: Anterior and posterior abdominal wall
Adrenergic antagonists: Beta blockers
Lipid-lowering medications: Statins
Lipid-lowering medications: Fibrates
Miscellaneous lipid-lowering medications
Antiplatelet medications
Thrombolytics
Assessments
Joint pain: Clinical (To be retired)
USMLE® Step 2 questions
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Transcript
Content Reviewers
Rishi Desai, MD, MPHContributors
Antonella Melani, MDJoint 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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