Manjari Lahiri Profile picture
Jun 6 6 tweets 12 min read Twitter logo Read on Twitter
Back to basics‼️

A tweetorial on a clinical approach to #joint #pain 🪡

The 🔠ABCDE approach

🅰️ Articular (or not!) 🦴
🅱️ Background (& burden) 🎒
C Chronology 🕰️
D Distribution 📍
E Extra-articular 🍂

Let’s dive deeper

#RheumTwitter ImageImageImage
#Pain is #inflammatory if worst in the AM/ after rest

#Swelling which is not bony #Synovitis the sine qua non of #inflammatory #arthrits

#Stiffness esp in AM & > 1 hour

“How do you feel when you wake in the morning?”

is a great question to ask

#RheumTwitter ImageImageImageImage

Age 🕰️
Gender ♈️♎️
Race 🧕🏻

And 🅱️ = Burden👩🏻‍🦼
#impact of disease

#RheumTwitter ImageImageImageImage
C 🟰Chronology 🕰️

6 wks is a (semi) arbitrary cut-off for ACUTE VS. CHRONIC #arthritis ; most viral arthritides will resolve in this time

Inflammatory arthritides are insidious onset

“Are you completely well at times” is a good question to ask
#RheumTwitter ImageImage

Pattern recognition is #key to making a #diagnosis of #rheumatic disease

👣The wrist is a small joint 🐣
👣The hip is an axial joint
👣Symmetry is relative 🫶🏽. Life is not perfect 🤷🏻‍♀️

#RheumTwitter ImageImageImageImage
E 🟰Extra-articular

🤌🏽 A good ROS is imperative.

🤌🏽 Problem representation helps to cast the net wide, and not forget to think OUTSIDE of the joints

Remember #CTD
Not all #inflammatory #arthritis is RA‼️


Credit: Julian Lim ⭐️ ImageImageImageImage

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