1/Arthritis is a complicated topic that may be frustrating. You may have heard it used synonymously with ARTHRALGIA - the two are different!
Let’s explore this topic with an open ended and introductory #medtweetorial dedicated to this broad topic, and how to best tackle it.

2/ Arthritis may present as a NON-inflammatory disease (Osteoarthritis AKA Degenerative arthritis).

3/ Inflammatory arthritis, on the other hand, is subcategorized by its cause. The major categories are:
1. autoimmune processes
2. crystal deposition
3. infection

4/ AUTOIMMUNE processes may cause rheumatoid arthritis (RA), psoriatic arthritis (PA), ankylosing spondylitis (AS).

5/ CRYSTALS are deposited in gout (G), pseudogout (PG), and basic calcium phosphate disease (BCPD).

6/ Arthritis from INFECTION may present as septic arthritis or Lyme’s arthritis.

7/ ....And if those 3 subcategories of inflammatory arthritis weren’t enough, it may also be seen along with CT disease (SLE, Sjogren syndrome, scleroderma, myositis, IBD, celiac disease - however, these are not the focus of this tweetorial).

8/ Which of the earlier examples of arthridities is the most common in the US?

9/ That is to say, most cases of arthritis are NON-INFLAMMATORY!
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(OA is the most common arthritis in the US.)

10/ I know what you’re thinking... So, which of the inflammatory arthridities are most common?!
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GOUT!

Gouty arthritis is the most common “inflammatory” arthritis in the US.

11/ So I know what’s most common, why is that important?
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It’s important because arthritis is a broad and complex topic. This is just scratching the surface.

12/ Once a “50,000 ft” view of the subject matter is appreciated by the clinician, they are better able to dx and tx the condition in most settings - especially if comorbidities exist (complicating the patient’s presentation).

13/ This concept of a “schema” for complex disease presentation, is new to me, but not to the lively and incredibly educational #CPSolvers I would love to see one centered around arthritis! I think the topic needs a little RnR. AKA Rabih and Reza @rabihmgeha @DxRxEdu

14/ Alas, arthritis is a broad topic that is best approached by being subdivided based on the presentation and findings of the patient, allowing its management in different cases. This is especially helpful when the disease cause is not as clear as one would like it to be.

15/ The American College of Rheumatology encourages an interprofessional approach when managing arthritis. To appreciate this “bird’s eye” view of classification, dx, and tx of arthritis, please visit:
https://www.ncbi.nlm.nih.gov/books/NBK518992/
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I hope you enjoyed this first #medtweetorial!

@RosenelliEM @MedTweetorials @ACRheum @nihrheumatology