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Approach to Patient with Unexplained Joint Pain

Joint pain can be caused by a variety of factors, ranging from common to rare, unpleasant to life-threatening. Even the most minor causes of joint discomfort can result in severe disability. A complete history and physical exam are required when evaluating a patient with joint pain (typically focusing on extra-articular symptoms), as well as the examination of joint fluid, serologies, and radiologic testing. The differential diagnosis of joint pain can be framed using three key questions. First, is the joint discomfort limited to a single joint or does it affect numerous joints? If the pain is only in one joint, the next question is whether it is monoarticular or extraarticular. Although the distinction may appear evident, changes in periarticular tissues can mimic articular illness. Finally, are the affected joints inflamed or not? Further down the spectrum, the sharpness of the pain may be significant.

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Dr. Rachit Gulati

Medical Director, Recoup Health, Bengaluru

Dr. Rachit Gulati, Medical Director, Recoup Health, Bengaluru

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Joint pain can be caused by a variety of factors, ranging from common to rare, unpleasant to life-threatening. Even the most minor causes of joint discomfort can result in severe disability. A complete history and physical exam are required when evaluating a patient with joint pain (typically focusing on extra-articular symptoms), as well as the examination of joint fluid, serologies, and radiologic testing. The differential diagnosis of joint pain can be framed using three key questions. First, is the joint discomfort limited to a single joint or does it affect numerous joints? If the pain is only in one joint, the next question is whether it is monoarticular or extraarticular. Although the distinction may appear evident, changes in periarticular tissues can mimic articular illness. Finally, are the affected joints inflamed or not? Further down the spectrum, the sharpness of the pain may be significant.