Determining the Cause

Chief Complaint: Joint Pain

Pivotal Assessment	Findings
History	Acute Onset Gradual Onset

Pivotal Assessment

Findings

History

Acute Onset

Gradual Onset

1. Medical History

Symptoms: severity, and type of pain (sharp, dull, throbbing, etc.).
Location: Specific joint(s) affected or if it's generalized.
Associated Symptoms: Swelling, redness, warmth, stiffness, fever, fatigue, rash, or other systemic signs.
Triggers or Alleviating Factors: Activities, rest, medications, or certain foods.
Past Medical History: Previous joint injuries, surgeries, or conditions such as arthritis, gout, or autoimmune diseases.

2. Physical Examination

Inspection: Look for visible swelling, redness, or deformity.
Palpation: Check for tenderness, warmth, or abnormal textures.
Range of Motion: Assess both active and passive movement.
Strength Testing: Evaluate surrounding muscles for weakness.
Joint Stability: Identify instability or unusual movements.

3. Laboratory Tests

Blood Tests: To identify inflammation, infection, or autoimmune markers (e.g., ESR, CRP, rheumatoid factor, anti-CCP, ANA, uric acid levels).
Synovial Fluid Analysis: If swelling is present, a joint aspiration can check for infection, gout crystals, or bleeding.

4. Imaging Studies

X-rays: Show joint space narrowing, bone spurs, fractures, or deformities.
MRI or CT Scans: Provide detailed images of soft tissues, cartilage, and ligaments.
Ultrasound: Helpful for detecting fluid accumulation or soft-tissue issues.
Bone Scan: Occasionally used for less obvious fractures or inflammatory conditions.

5. Specialized Tests

Electromyography (EMG): If nerve involvement is suspected.
Dual-energy CT Scan: To detect urate crystals in gout.

6. Clinical Diagnosis

Based on the findings, the physician correlates clinical symptoms, test results, and imaging studies to determine the cause. Common diagnoses include:

Osteoarthritis: Degenerative wear and tear.
Rheumatoid Arthritis: Autoimmune inflammation.
Gout: Uric acid crystal deposits.
Bursitis or Tendinitis: Inflammation of supportive structures.
Infectious Arthritis: Bacterial or viral joint infection.
Trauma or Overuse Injuries: Strains, sprains, or fractures.

If the diagnosis remains unclear, referral to a specialist such as a rheumatologist or orthopedic surgeon may be necessary.