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Query: UMLS:C0184567 (acute pain)
 3,962 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We recommend that physicians distinguish shoulder arthritis from periarticular disorders. A specific diagnosis should be made in the former, if possible. A number of arthritides have frequent shoulder involvement, and they should be kept in mind. Septic arthritis should always be suspected when there is acute pain and swelling. Joint fluid aspiration should almost always be performed when fluid is present. The diagnosis of gout or CPPD deposition disease usually requires crystal identification from joint fluid for diagnosis. Treatment of shoulder arthritis with oral anti-inflammatory medication is usually indicated; appropriate treatment of the underlying disorder, e.g., rheumatoid arthritis, is necessary. Physical therapy started early, often combined with IA corticosteroids, helps to maintain or improve shoulder motion.
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PMID:Causes and management of shoulder arthritis. 327 36

Toxic synovitis, an acute inflammatory condition of the hip, is the most common cause of limp and acute pain of the hip in children under 10 years of age. Usually, the synovitis and joint effusion are present unilaterally. The etiology of the condition is unknown, although in a few cases a recent history of an upper respiratory tract infection may be present. The child with toxic synovitis may complain of a limp and pain in the hip, the anteromedial aspect of the thigh, and the knee. The white cell count and erythrocyte sedimentation rate may be slightly elevated, as is the body temperature. Ultrasound is recommended as the primary imaging tool in the diagnosis and treatment of toxic synovitis. Septic arthritis, Perthes disease, and osteomyelitis are a few of the differential diagnoses that the practitioner should consider. Most cases can be managed with bed rest at home and administration of a nonsteroidal anti-inflammatory medication. Follow-up care should occur 2 weeks after diagnosis to ensure there is no recurrence of the joint effusion or progression to avascular necrosis. Radiographs of the hip should be repeated at 1 month and 3 months to complete the patient follow-up.
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PMID:Toxic synovitis of the hip in children. 759 30

A pediatric case of Cogan's syndrome mimicking acute Lyme arthritis is described. A 12-year-old black boy was admitted to the pediatric service for presumed right knee septic arthritis. Symptoms included acute pain and swelling with decreased range-of-motion. Although the patient's right knee symptoms and positive Lyme serology were consistent with a diagnosis of Lyme arthritis, the presence of sensorineural hearing loss and interstitial keratitis with inflammatory arthritis suggested a diagnosis of Cogan's syndrome. Subsequent Western blot analysis was negative for Borrelia burgdorferi antigens. The patient had dramatic clinical improvement of musculoskeletal and ophthalmologic complaints shortly after receiving high-dose corticosteroids, although residual sensorineural hearing loss persisted.
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PMID:Cogan's syndrome mimicking acute Lyme arthritis. 762 Aug 65

Neisseria gonorrhoeae is an uncommon present-day cause of septic arthritis. It is generally seen in the younger patient population and is often difficult to isolate in the lab. Blood cultures performed as routine work are usually negative, and when positive tend to be seen in the classic form of disseminated gonococcal infection. Here we report a case of acute septic monoarthritis, associated with N. gonorrhoea bacteraemia, in a 67-year-old male patient with multiple chronic comorbidities, who presented with acute pain and swelling at his left elbow, and no associated skin changes. Arthrocentesis findings were consistent with septic arthritis. Blood cultures drawn on admission grew N. gonorrhoeae. Synovial fluid culture was sterile but did exhibit Gram-negative cocci on Gram stain. The patient was started on IV antibiotics, and later underwent incision and drainage with subsequent improvement in symptoms. We thus present an unusual form of disseminated gonococcal infection in the setting of: epidemiology, physical presentation, as well as microbiologic findings. Although less common, DGI should be considered in the differential for septic join in the older adult population, and a sexual history should be obtained in all patients. This patient ultimately had an excellent outcome given his prompt presentation after symptom onset and immediate initiation of medical therapy.
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PMID:Acute septic elbow monoarthritis with associated Neisseria gonorrhoeae bacteraemia: an uncommon presentation of an old disease. 3248 91

Septic arthritis of the temporomandibular joint (TMJ) is a rare condition, particularly in the paediatric population. Our case involves a 15-year-old unvaccinated Amish man with acute pain and trismus of the TMJ. The diagnosis was reached after history, clinical examination, radiographic and laboratory examinations were performed. The patient improved after a minimally invasive surgical procedure and medical therapy. Failure to recognise and treat septic arthritis in a timely fashion can result in serious sequalae. Infectious aetiologies should be kept on the differential for any patient with acute TMJ pain.
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PMID:Septic arthritis of the temporomandibular joint in an unvaccinated adolescent. 3264 38