Articular vs Nonarticular Characteristics
ArticularNonarticular
1. Anatomic Structures: Juxtaarticular bone, Articular cartilage, Intraarticular ligaments, Menisci (knee), Synovial fluid, Synovium, Joint capsule
2. Symptoms and Signs
a. Pain/tenderness: Localized to joint, Deep and poorly localized, Specific referral patterns
b. Pain on Movement: With active and passive movement, With movement in many planes, Localized to joint
c. Swelling: Common, Related to articular structure; Synovial effusion, Synovial thickening, Bony enlargement
d. Limitation of Motion: Frequent on both passive and active range of movement, Related to mechanical derangement or joint pain
e. Crepitation: May be present
f. Instability: May be present
g. Locking of joint: May be present
h. Deformity: May be present, Localized to joint, Secondary to joint damage
3. Radiographic changes: Common in chronic conditions, Uncommon in acute conditions except trauma
1. Anatomic Structures: Tendons, Bursae, Extraarticular ligaments, Muscle, Fascia, Bone, Nerve, Skin
2. Symptoms and Signs
a. Pain/tenderness: Localized to extraarticular structure, Point tenderness, superficial
b. Pain on Movement: With active movement, With movement in specific planes, Not or rarely localized to joint
c. Swelling: May be present, Not limited to articular structure
d. Limitation of Motion: May be present but usually limited to active range of movement, Related to extraarticular mechanical abnormality, diffuse pain, or weakness
e. Crepitation: Absent/unrelated
f. Instability: Absent/unrelated
g. Locking of joint: Absent/unrelated
h. Deformity: Rare, except with antecedent trauma, Associated with extraarticular abnormality
3. Radiographic changes: Uncommon/unrelated, Soft tissue calcification
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reference: Lipsky P. Algorithms for the diagnosis and management of musculoskeletal complaints: A new tool for the primary-care provider. Am J Med. 1997 Dec 29;103(6A):1S-2S.
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See also Articular versus Nonarticular Arthritis Characteristics
See also Inflammatory versus Noninflammatory Arthritis Characteristics
See also Testing for Inflammatory Arthritis
See also the Chronic Inflammatory Polyarthritis Decision Tool
See also the Spondyloarthropathy Decision Tool
See also the Rheumatoid Arthritis Likelihood Decision Tool
See also the 2010 American College of Rheumatology/European League Against Rheumatism Criteria calculator

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