Pre PACES Podcast #88 Acute monoarthropathy
May 26, 2024
Join Dr. Ben Mulhearn, a soon-to-be consultant rheumatology registrar, as he dives into the nuances of acute monoarthropathy. He explains why all doctors need to master the assessment of hot swollen joints. Discover how to differentiate septic from crystal arthritis and why joint aspiration is crucial. Ben also discusses lifestyle factors for gout and challenges common myths, such as the risks of giving steroids before ruling out sepsis. Packed with practical insights, this conversation is vital for any medical professional.
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Teaching F2s Highlighted Frequency Of Monoarthritis
- Dr Ben recounts teaching F2s how to aspirate and found every trainee had encountered monoarthritis.
- He uses this to emphasise the condition's ubiquity and the need to learn aspiration skills.
Clinical Signs And Blood Tests Are Not Definitive
- You cannot reliably distinguish septic arthritis from crystal or inflammatory arthritis by exam or blood tests alone.
- Dr Ben Mulhearn stresses aspiration and culture are essential to confirm infection before assuming a diagnosis.
Time Course And Demographics Guide Diagnosis
- Ask how quickly the joint became inflamed: hours/days/weeks dramatically alters the likely causes.
- Use age, sex and risk factors to target your differential (e.g., gout in overweight men, reactive in sexually active younger patients).