Question
What systemic conditions can contribute to elbow pain, and how can they be identified?
Answer
Several systemic conditions can cause elbow pain, making differential diagnosis essential in clinical assessment. Autoimmune diseases such as systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) can lead to joint inflammation, swelling, and progressive joint damage. Patients with SLE may present with additional systemic symptoms such as fatigue, rashes, and malar erythema, whereas RA often manifests with morning stiffness, bilateral joint involvement, and progressive deformities. Psoriatic arthritis, another autoimmune condition, can cause joint pain along with skin and nail changes such as pitting and onycholysis.
Metabolic conditions like gout and diabetes mellitus can also contribute to elbow pain. Gout, caused by uric acid crystal deposition in the joint, leads to sudden, intense pain, redness, and swelling. Diabetes, particularly when poorly controlled, can result in peripheral neuropathy and increased risk of infections like osteomyelitis. Clinicians should carefully review patient history, systemic symptoms, and relevant laboratory findings, such as inflammatory markers and uric acid levels, to distinguish between these conditions.
This Ask the Expert is an edited excerpt from the course, "Demystifying Elbow Pain Through Case Studies, Part 2," presented by Rina Pandya, PT, DPT, FHEA, PGLTHE.