Differential Diagnosis for Joint Pain
Joint pain has dozens of causes. When a patient complains of joint pain and the reason isn't obvious the doctor will perform a differential diagnosis to determine if it is caused by arthritis or demographics, if the pain is chronic or acute, if they are presenting any systemic features, if there is a joint involvement pattern and if it is an inflammatory or a non-inflammatory condition.
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Articular, Nonarticular or Periarticular
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When making a differential diagnosis of joint pain a doctor must try to determine what type of structure is causing the pain. According to the University of Washington, the periarticular causes include bursitis, fibromyalgia/myofacial pain, fasciitis, epicondylitis, injured ligaments and tendinitis. The nonarticular causes include bone tumors, vasculopathy, radiculopathy, nerve entrapment, neuroma and osteomyelitis.
Chronic or Acute
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Determining whether the joint pain stems from a chronic or acute condition is also part of a differential diagnosis. According to the University of Washington, an acute condition lasts less than eight weeks and chronic conditions last more than eight weeks. Acute conditions are typically not indicative of a larger problem and the onset is rapid.
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Inflammatory or Non-Inflammatory
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When making a differential diagnosis for joint pain a doctor will seek to determine whether the patient is suffering from an inflammatory or a non-inflammatory disorder. According to the University of Washington, patients with an inflammatory disorder often experience stiffness in the morning that lasts longer than 30 minutes. Their stiffness will often get worse when they rest but improve with physical activity, and joint swelling may also be present. Patients with a non-inflammatory condition may experience mild stiffness in the morning (often lasing less than 15 minutes), and their pain will increase with physical activity and decrease when they rest. These patients may or may not experience joint swelling.
Arthritis
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Doctors also try to determine whether arthritis is the cause of the joint pain through diagnostic testing, which may include blood and urine analysis, a physical exam and imaging.
Demographics
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Doctors often focus on the patient's demographics when performing a differential diagnosis for joint pain. According to the University of Washington, the demographics they consider include age, gender, race and lifestyle. Doctors also typically ask patients about their medical history and what medications they are taking.
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