Important differentiation points :-
1- Joint exam --> Warm, swelling, tenderness
2- Prolonged morning stiffness
3- Duration and distribution
4- Constitutional symptoms (fever, weight loss)
5- Extra-Articular symptoms and signs (ocular, pulm, renal, dermatological)
6- Labs and seropositivity
Non inflammatory 200 to 2000
Inflammatory (Crystal) 2000 - 50,000
Inflammatory (Septic) ≥ 50,000
Gram positive Cocci in clusters (staph Aureus)
Gram positive Cocci in chains (strept Sp.)
Gram negative diplococci (gonorrhea)
Negative Birefringent (yellow) Needle shaped crystal --> Monosodium urate crystals --> Gout
Positive Birefringent (blue) Rhomboid shaped crystals --> Calcium Pyrophosphate Crystals --> Pseudogout
Septic Arthritis can present with crystals. Don't be fooled
Clinical Presentation
1-
Important differentiation points :-
1- Joint exam --> Warm, swelling, tenderness
2- Prolonged morning stiffness
3- Duration and distribution
4- Constitutional symptoms (fever, weight loss)
5- Extra-Articular symptoms and signs (ocular, pulm, renal, dermatological)
6- Labs and seropositivity
Non inflammatory 200 to 2000
Inflammatory (Crystal) 2000 - 50,000
Inflammatory (Septic) ≥ 50,000
Gram positive Cocci in clusters (staph Aureus)
Gram positive Cocci in chains (strept Sp.)
Gram negative diplococci (gonorrhea)
Negative Birefringent (yellow) Needle shaped crystal --> Monosodium urate crystals --> Gout
Positive Birefringent (blue) Rhomboid shaped crystals --> Calcium Pyrophosphate Crystals --> Pseudogout
Septic Arthritis can present with crystals. Don't be fooled
Clinical Presentation
1-
