Muscle pain: Differential Diagnosis by Symptom Pattern

• •Prioritize red flags and severe progression first
• •Use focused history + exam to define the leading organ system

• •Character of pain and exertional trigger
• •Hemodynamic instability, pulse pattern, and blood pressure
• •ECG and cardiac biomarkers trend

• •Sudden vs progressive neurologic deficit
• •Focal deficits, consciousness changes, and meningeal signs
• •Headache phenotype and trigger pattern

• •Mechanical vs inflammatory pain profile
• •Morning stiffness and functional pattern
• •Joint distribution and systemic autoimmune clues

• •Pattern of cough, dyspnea, and pleuritic pain
• •Oxygen saturation and respiratory rate
• •Auscultation findings and imaging pattern

Immediate testing when red flags are present

• •Focused examination with baseline labs if symptoms persist
• •Escalate to urgent workup when red flags appear

Group-directed workup

• •ECG
• •Troponin
• •Blood pressure in both arms
• •Echocardiography when indicated
• •Focused neurologic exam
• •CT/MRI when red flags are present
• •Lumbar puncture when indicated
• •Glucose and electrolytes