Extra-articular and Other Conditions Associated with Joint Pain



Eyes

  • Iritis or uveitis - Spondyloarthropathies, Sarcoidosis, GPA

  • Conjunctivitis - Spondyloarthropathies, SLE, GPA

  • Cytoid bodies (retinal exudates) - SLE

  • Scleritis - RA, Relapsing polychondritis, GPA

  • Ischemic optic neuritis - Giant cell arteritis, GPA

  • Iridocyclitis - Juvenile idiopathic arthritis



Nails

  • Onycholysis - Psoriatic arthritis, Hyperthyroidism

  • Pitting - Psoriatic arthritis

  • Clubbing - IBD, Whipple's disease, Hyperthyroidism



Fever

  • Bacterial or viral infection

  • Still's disease

  • Subacute bacterial endocarditis

  • Neoplasm



Nodules

  • RA

  • Gout

  • Whipple's disease

  • Rheumatic fever

  • Amyloidosis

  • Sarcoidosis

  • Tophi

      - Gout

• Jaundice

  - Hepatitis

  - Hemochromatosis

• Hyperpigmentation

  - Whipple's disease

  - Hemochromatosis



GI

  - Felty syndrome

  - Spondyloarthropathy-IBD

  - Splenomegaly

      • Felty's syndrome

      • Tumor-associated arthritis

  - Hepatomegaly

      • Whipple's disease

      • Hemochromatosis

      • Amyloidosis

      • Wilson's disease



Pulmonary

  • Interstitial lung disease - Spondyloarthropathies, SLE

  • Pulmonary nodules - RA, SLE

  • Pleural disease - RA - SLE

  • Bronchiectasis - RA

  • Shrinking lung syndrome - SLE



Neurologic system

  • Entrapment neuropathies - RA, Hypothyroidism, Hyperparathyroidism

  • Facial palsy - Lyme disease

  • Peripheral neuropathy - SLE, Amyloidosis

  • Chorea - Antiphospholipid-antibody syndrome, SLE, Rheumatic fever

  • Mononeuritis multiplex - RA, SLE, Lyme disease, Vasculitis (e.g., PAN)

  • Seizures - SLE



Genitourinary system

  • Prostatitis - Reactive arthritis, Ankylosing spondylitis

  • Urethritis or cervicitis - Reactive arthritis, Gonococcal arthritis

  • Scrotal or vulvar ulcers - Behçet's syndrome

  • Hypogonadism - Hemochromatosis

  • Balanitis circinata - Reactive arthritis



ENT

  • Oral ulcers - SLE, Behçet's syndrome, Reactive arthritis, GPA

  • Parotid enlargement - Sjögren's syndrome, Sarcoidosis

  • Macroglossia - Amyloidosis

  • Scalp tenderness - Giant cell arteritis

  • Bloody or severe sinusitis - GPA

  • Inflammation of ear, sparing the lobe - Relapsing polychondritis



Telangiectasia

  • Scleroderma



Thickened skin

  • Scleroderma

  • Amyloidosis

  • Eosinophilic fasciitis



Hair thinning

  • Hypothyroidism

  • SLE



Musculoskeletal System Tender points

  • Fibromyalgia



Heberden's nodes (DIP joints), Bouchard's nodes (PIP joints)

  • Osteoarthritis



Boutonnière and swan-neck deformities

  • RA, SLE, Ehlers-Danlos syndrome

   

Dactylitis of digits

  • Psoriatic arthritis



Lymphadenopathy

  • Tumor-associated arthritis

  • SLE



Cardiovascular system

  • Mitral regurgitation and stenosis - Rheumatic fever

  • Aortic regurgitation - Ankylosing spondylitis, Rheumatic fever, Relapsing polychondritis, Reactive arthritis, Marfan syndrome, Takayasu's arteritis

  • Cardiomyopathies - Viral infection, Amyloidosis, Sarcoidosis, SLE, Polymyositis

  • New murmur, fever - Bacterial endocarditis, Rheumatic fever

  • Diminished peripheral pulses - Giant cell arteritis, Takayasu's arteritis



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