musculoskeletal and connective tissue disorders
Pain in and Around a Single Joint
Etiology of Pain in a Single Joint
The most common causes of acute monoarticular pain overall are the following: Injury Infection Crystal-induced arthritis With injury, a history of trauma is usually present and suggestive. Injury can affect intra-articular and/or periarticular structures and involve direct injury (eg, twisting during a fall) or overuse (eg, repetitive motion, prolonged kneeling). Infection most often involves the joint ( Acute Infectious Arthritis ), but periarticular structures, including bursae, overlying skin, and adjacent bone, also may become infected. Among young adults,the most common causes are the following: Injury (most common) Infection Primary inflammatory disorders (eg, Gout ) Among older adults,the most common nontraumatic causes are the following: Osteoarthritis (OA) (most common) Crystal-induced arthritis (usually gout or Calcium Pyrophosphate Arthritis [previously called pseudogout]) The most dangerous cause of joint pain at any age is Acute Infectious Arthritis . Prompt drainage, IV antibiotics, and sometimes operative joint lavage may be required to minimize permanent joint damage and prevent sepsis and death. Rarer causes of monoarticular pain include Osteonecrosis (ON) , The most common cause of periarticular pain is injury, including overuse. Common periarticular disorders include Bursitis and Sometimes, pain is referred to a joint. For example, a splenic injury may cause left shoulder pain, and children with a hip disorder may complain of knee pain. 