Beyond osteoarthritis: recognizing and treating infectious and other inflammatory arthropathies in your practice.
About 15% of patients presenting in a primary care clinic have joint pain as their primary complaint (level B). Disseminated gonorrhea is the most common cause of infectious arthritis in sexually active, previously healthy patients (level B). Prompt arthrocentesis, microscopic examination, and the culture of any purulent material plus appropriate antibiotic therapy are the mainstay of treatment in infectious arthritis (level C). Detailed history, including family history and comprehensive examination, is more useful in accurate diagnosis than expensive laboratory and radiological investigations for noninfectious arthritis (level C). Regarding inflammatory noninfectious arthritis with the potential to cause destructive joint damage, early referral to a subspecialist, when indicated, increases the likelihood of optimal outcome (level C). Nonsteroidal antiinflammatory drugs are the first line of therapeutic agents to reduce pain and swelling in the management of most noninfectious inflammatory arthritis seen in the primary care office (level C).
Hinsdale Family Medicine Residency, Hinsdale, IL, USA. Zewdu.Haile.MD@ahss.org
Zewdu
Z
Haile
Sanjeeb
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Khatua
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000465:Algorithms; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001170:Arthritis, Infectious / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D001691:Biological Therapy; D006801:Humans; D007249:Inflammation / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology; D007592:Joint Diseases; D010003:Osteoarthritis / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D058007:Physicians, Primary Care; D011320:Primary Health Care; D013582:Synovial Fluid / Q000737:chemistry
D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal