Inflammatory Joint Pain - Differential Diagnosis Algorithm 

Monoarticular

 • Gout (Podagra, Tophi)

 • Pseudogout

 • Early Rheumatic Disease

 • Reactive (e.g. Genitourinary Infection)

Oligoarticular (1-4 joints)

 • Gout

 • Psoriatic (Nail Changes, Plaques)

 • Enteropathic (e.g. Inflammatory Bowel Disease)

 • Reactive

 • Rheumatic Fever (recent Pharyngitis, Carditis)

 • Lyme Disease (Tick bite, Migratory red Macules)

POLYARTICULAR (>4 joints)

Subacute & Symmetrical

 • Rheumatoid Arthritis

 • Systemic Lupus Erythematosus

 • Sjögren's (a.k.a. Sicca) Syndrome

 • Scleroderma

 • Henoch-Schonlein Purpura

 • Polymyalgia Rheumatica

 • Granulomatosis with polyangiitis (GPA)/microscopic polyangiitis (MPA)

Insidious Monoarticular

 • Symmetric (Polymyositis/Dermatomyositis)

 • Asymmetric (Psoriatic Arthritis)

Migratory

 • Rheumatic Fever

Acute Onset

 • Reactive

Insidious Onset

 • Ankylosing Spondylitis

 • Enteropathic (e.g. Inflammatory Bowel Disease)

 • Psoriatic Arthritis



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