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Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 7e
| Section 23. Musculoskeletal Disorders > |
Chapter 281. Acute Disorders of the Joints and Bursae
Sections: Acute Disorders of the Joints and Bursae: Introduction, Clinical Approach to Acute Joint Pain, Arthrocentesis, Septic Arthritis, Crystal-Induced Synovitis (Gout and Pseudogout), Viral Arthritis, Lyme Disease, Hemarthrosis, Rheumatoid Arthritis, Osteoarthritis, Reactive Arthritis, Ankylosing Spondylitis, Bursitis, Practice Guidelines, References.
Topics Discussed: arthritis; bursitis; joint disorders.
Excerpt:"Many mechanisms provoke acute joint symptoms: degradation and
degeneration of articular cartilage (osteoarthritis), deposition
of immune complexes or immune system–related phenomena
(rheumatoid arthritis, rheumatic fever, and, possibly, a component
of gonococcal arthritis), crystal-induced inflammation (gout and
pseudogout), seronegative spondyloarthropathies (ankylosing spondylitis—primarily
genetic, and reactive arthritis—postinfectious with HLA-B27
susceptibility), and bacterial invasion (gonococcal and nongonococcal
septic arthritis, including Lyme arthritis), or viral invasion (viral
arthritis). These processes impact joint capsules and surfaces,
resulting in a cascade of reactive and inflammatory events. The
term septic arthritis refers to the invasion of
a joint by an infectious agent with proliferation and associated
inflammation; bacterial arthritis is a subset of septic arthritis.
Under ideal conditions, the infectious agent is recoverable from
the joint fluid in septic arthritis, but in practice, this may not
occur. This chapter reviews the common causes and treatments of
acute nontraumatic joint pain. Joint injuries are discussed in Section
22, Injuries to Bones and Joints, and disorders due to repetitive
use syndromes..."
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