ppy

2. Fever with arthritis
• SLE
• Viral arthritis
• Vasculitis
• Rheumatic Fever
• AOSD
• Brucellosis

3. Raynaud’s phenomenon
• Scleroderma (commonest)
• SLE
• RA
• Sjogrens
• Myositis

4. Oral ulcer
Painless
• SLE
• Reactive arthritis
• Enteropathic
Painful
• Bechet

5. Arthritis with….
Neuropathy
• SLE
• Vasculitis
• Lyme
• RA
• Amyloidosis
• Cryoglobulinemia
Pulmonary
• AAV(cough,
hemoptysis,
pleuritis)
• SLE (Pleuritis)
• Scleroderma
(ILD,PAH)
• RA (Pleural effussion,
pulmonary
nodules,ILD)

6. Arthritis with….
Renal invovement
• SLE
• Vasculitis
• Sjogren
• RA
• Amyloidosis
• Cryoglobulinemia
GI involvement
• SLE (intestinal
vasculitis)
• Scleroderma (GERD,
diarrhea, pseudo-
obstruction)
• Enteropathic (IBD)
• PAN (Mesenteric
vasculitis)

7. Ocular
Keratoconjunctivitis sicca
• Sjogren syndrome, RA, SLE
Uveitis
• SpA, Sarcoidosis, Bechet’s, GPA
Scleritis
• GPA, RA, SLE

8. Family History
• RA
• OA
• AS
• Gout
• Psoriasis

9. Drug History
• Drug induced lupus: Hydralazine, ACE-
inhibitor
• Arthralgia: Quinolones
• Gout: Diurestics
• Vasculitis: Allopurinol, Thiazides
• Scleroderma: Bleomycin
• Osteonecrosis: Glucocorticoid

10. History of malignancy
Carcinomatous polyarthritis:
• Solid organ (Breast, colon, ovarian, lung)
• Lymphoproliferative disease
RS3PE (Relapsing seronegative symmetric
synovitis with pitting edema):
• Lymphoma
• Myelodysplastic syndrome

11. Physical Examination
• Inspection
• Palpation
• Assessment of range of motion

12. Investigation
• Blood test
1. Hematology
2.Biochemistry: Uric acid, ESR, CRP
3. Immunology: RF, ANA

13. Joint Aspiration
Arthrocentesis (Synovial Fluid Analysis)
• Indicated when there is warm, red joint with
effusion, especially when there is no history of
trauma
• Aspirated synovial fluid should be sent for 3Cs:
1. Cell count
2. Crystals: for Gout and Pseudogout
3. Culture (gram stain): for Septic arthritis

14. Diagnostic imaging
Indication:
• Bony tenderness
• Inability to bear
weight
• Gross deformity
• Age
Modalities :
• Plain flim
• USG
• CT scan
• MRI

15. Reference
• Clinical Rheumatology- Springer 2019- Rohini
Handa
• Kelly’s Rheumatology

16. Thank you