Joint pain: a practical guide to the diagnosis of arthritis

Romero Gómez, C.; Rodríguez Rodríguez, R.; Lozano Fernández, D.; Hernández Negrín, H.

doi:10.1016/j.rceng.2026.502617

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Abstract

Joint pain is one of the most common reasons for consultation in clinical practice, and its correct interpretation presents a diagnostic challenge due to the wide variety of causes and clinical presentations.

The assessment of joint pain requires a structured clinical approach that allows differentiation between joint and extra-articular causes and distinguishes between inflammatory and non-inflammatory processes. A detailed medical history and targeted physical examination form the cornerstone of the diagnostic process, facilitating the identification of clinical patterns based on the number of joints affected, their distribution and the course of the condition over time.

Supporting investigations, including laboratory tests, synovial fluid analysis and imaging techniques, should be used judiciously and always within the clinical context, avoiding indiscriminate testing.

This approach allows for the early recognition of potentially serious conditions, the identification of warning signs and the optimisation of decision-making in clinical practice.

Keywords:

Arthritis

Musculoskeletal pain

Polyarthritis

Monoarthritis

Resumen

El dolor articular es uno de los motivos de consulta más frecuentes en la práctica clínica, y su correcta interpretación constituye un desafío diagnóstico debido a la heterogeneidad de sus causas y formas de presentación.

La evaluación del dolor articular requiere un enfoque clínico estructurado que permita diferenciar el origen articular del extraarticular y distinguir entre procesos inflamatorios y no inflamatorios. La anamnesis detallada y la exploración física dirigida constituyen el eje del proceso diagnóstico, facilitando la identificación de patrones clínicos según el número de articulaciones afectadas, su distribución y la evolución temporal.

Las pruebas complementarias, incluyendo laboratorio, análisis de líquido sinovial y técnicas de imagen, deben utilizarse de forma racional y siempre en el contexto clínico, evitando su uso indiscriminado.

Este abordaje permite reconocer precozmente entidades potencialmente graves, identificar signos de alarma y optimizar la toma de decisiones en la práctica clínica.

Palabras clave:

Artritis

Dolor musculoesquelético

Poliartritis

Monoartritis

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