Not every back pain or joint ache is mechanical, and this session is designed to sharpen your clinical instincts for spotting what lies beneath. Focused on seronegative spondyloarthropathies and their extra-spinal patterns, this module highlights when that nagging “disc problem” could in fact be an autoimmune disease masquerading as mechanical pain. You’ll learn a practical, office-based approach to differentiating inflammatory pain from degenerative conditions, from subtle heel pains and enthesitis to unexplained peripheral arthritis and sacroiliitis with a normal MRI.
Importantly, the session will cover when to suspect inflammatory tendinopathies in chronic elbow, heel, and shoulder pain cases and how to screen them for possible underlying rheumatologic diseases. A significant focus will be on DMARDs (Disease-Modifying Anti-Rheumatic Drugs), understanding when to consider them, the difference between conventional (like methotrexate, sulfasalazine) and biologic DMARDs, and when to refer to a rheumatologist. Practical discussions will clarify how long to wait before initiating DMARD therapy, what investigations are mandatory before starting, and how to monitor patients already on these medications.
We’ll also unpack traditional treatment regimens like the Mukherjee Regimen and critically examine whether its widespread use in seronegative arthritis still holds up to contemporary evidence.
Expect a highly practical, pattern-based learning module that bridges the gap between orthopedics, rheumatology, and pain practice.