Differentiating Articular vs. Periarticular Complaints

Introduction

Musculoskeletal complaints are common in orthopaedic practice. Differentiating between articular (joint-related) and periarticular (surrounding soft tissue-related) conditions is crucial for accurate diagnosis and effective management.

Definition and Characteristics of Periarticular Complaints

Periarticular complaints refer to pain and dysfunction originating from structures adjacent to a joint, such as tendons, bursae, muscles, ligaments, and nerves. These conditions often mimic joint pathologies, making clinical differentiation essential.

Key Differences Between Articular and Periarticular Disorders

• Articular Disorders: Characterized by swelling, stiffness, and restricted range of motion within the joint itself.
• Periarticular Disorders: Manifest as localized pain, tenderness over soft tissues, and preservation of joint mobility with pain upon movement.

Common Periarticular Conditions

• Tendinitis: Inflammation of a tendon, often caused by overuse or repetitive strain.
• Bursitis: Inflammation of a bursa due to friction or trauma.
• Muscle Strains: Overstretching or tearing of muscle fibers.
• Nerve Entrapment Syndromes: Conditions like carpal tunnel syndrome, where nerves are compressed, leading to pain and sensory disturbances.

Diagnosis and Management

Proper evaluation includes a thorough history, physical examination, and imaging studies such as ultrasound or MRI to distinguish periarticular issues from true joint pathology.

Treatment typically involves:

• Rest and activity modification.
• Physical therapy and strengthening exercises.
• Anti-inflammatory medications or corticosteroid injections.
• Invasive procedures in refractory cases.

Conclusion

Differentiating periarticular from articular complaints is vital for accurate diagnosis and treatment. Recognizing the distinct characteristics of periarticular conditions helps clinicians optimize patient care and prevent unnecessary interventions.