Health Dictionary
Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.
Monoarthritis with joint swelling and fever
Introduction
| Diseases | Clinical manifestations | Para-clinical findings | Gold standard | Additional findings | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Symptoms | Physical examination | ||||||||||||||||||
| Lab Findings | Imaging | Histopathology | |||||||||||||||||
| Joint Swelling | Fever | Weight loss | Claudication | Morning stiffness | Local erythema | Skin manifestation | CBC | ESR | Synovial fluid | Other | X-ray | CT scan | Other | ||||||
| Monoarthritis | Infection | Gonococcal infection[1] | + | + | – | – | – | + | Maculopapular, Pustular, Vesicular lesions on an erythematous base | Leukocytosis | ↑ | Purulent with cell count > 50,000 WBC/µL (with PMNs > 90%) | Blood and synovial fluid culture | Minor articular damage | – | – | Dermal vasculitis with perivascular neutrophils | Nucleic acid amplification tests (NAATs) | Dermatitis, Tenosynovitis |
| Nongonococcal bacterial infections[2] | + | + | – | – | – | + | Local erythema | Leukocytosis | ↑ | Purulent with cell count > 50,000 WBC/µL (with PMNs > 90%) | Blood and synovial fluid culture | Joint effusion, Cartilage destruction, Joint space narrowing | Sternoclavicular or sacroiliac joint infections | Periarticular osteomyelitis in MRI | – | Synovial fluid culture | Limping, Malaise | ||
| Lyme disease[3] | + | + | +/- | +/- | – | – | Erythema migrans | Leukopenia, Thrombocytopenia | – | Cell counts 500-98,000/µL | Microscopic hematuria, Proteinuria, ↑ALT or AST | Knee joint effusion. Intra-articular edema | – | Unspecific effusion, Synovial thickening or enhancement in MRI | Fibrosis of the deeper dermis and hyalinization of collagen bundles | Serologic tests | Erythema migrans | ||
| Crystal-induced arthritis | Gout[4] | + | +/- | – | – | – | + | Local swelling and erythema | Leukocytosis | ↑ | Needle shaped urate crystals, WBC count > 2000/µL | Urinary uric acid (>1100 mg in 24h) | Punched-out erosions or lyticareas with overhanging edges | Complementary for recognizing erosions | Tophi or edema in MRI | Large pale pink acellular areas (urate crystals), surrounded by histiocytes and multinucleated giant cells | Synovial fluid microscopy | Conjunctival nodules | |
| Systemic disorders | Reactive arthritis[5] | +/- | +/- | – | – | – | – | Genital ulceration | Normocytic normochromic anemia | ↑ |  High WBC count (10,000-40,000/µL) |  HLA-B27 test | Periosteal reaction and proliferation of tendon insertion site | Sacroiliitis | Enthesitis in ultrasonography | Keratoderma blennorrhagicum,Balanitis circinata |  Spondyloarthritis and unequivocal demonstration of preceding infection | Conjunctivitis, Uveitis | |
| Inflammatory bowel disease-associated arthritis[6] | + | + | – | – | + | +/- | Pyoderma gangrenosum(ulcerative colitis),Erythema nodosum(Crohn disease) | Iron deficiency anemia, Leukocytosis, Thrombocytosis | ↑ | Mild to moderate inflammatory fluid, PMNpredominance | ↑RF, Antiendomysial Ab,Antitransglutaminase Ab | Bilateral sacroiliitis, Syndesmophytes and apophyseal joint involvement in spine | – | Early detection of spinal and sacroiliac lesions in MRI | – | Clinical findings and history | Acute anterior uveitis | ||
| Myelodysplastic and leukemic disorders[7] | + | + | + | +/- | – | – | Petechia and purpura | Anemia, | ↑ | WBC count >2000/µL (inflammatory), with neutrophilpredominance | LDH, Uric acid | Articular surface erosion, Synovial effusion | Thickened synovium | Synovitis in MRI | Inflammatory cells infiltration in synovial tissue | Bone marrow biopsy | Fatigue, Nausea, Recurrent infections | ||
References
- ↑ Bardin T (April 2003). “Gonococcal arthritis”. Best Pract Res Clin Rheumatol. 17 (2): 201–8. PMID 12787521.
- ↑ GarcÃa-De La Torre I, Nava-Zavala A (February 2009). “Gonococcal and nongonococcal arthritis”. Rheum. Dis. Clin. North Am. 35 (1): 63–73. doi:10.1016/j.rdc.2009.03.001. PMID 19480997.
- ↑ Arvikar SL, Steere AC (2015). “Diagnosis and treatment of Lyme arthritis”. Infect Dis Clin North Am. 29 (2): 269–80. doi:10.1016/j.idc.2015.02.004. PMC 4443866. PMID 25999223.
- ↑ Reginato A, Paul H, Schumacher HR (September 1982). “Crystal-induced arthritis”. Arch Phys Med Rehabil. 63 (9): 401–8. PMID 6287963.
- ↑ Colmegna I, Cuchacovich R, Espinoza LR (2004). “HLA-B27-associated reactive arthritis: pathogenetic and clinical considerations”. Clin Microbiol Rev. 17 (2): 348–69. PMC 387405. PMID 15084505.
- ↑ Orchard TR (2012). “Management of arthritis in patients with inflammatory bowel disease”. Gastroenterol Hepatol (N Y). 8 (5): 327–9. PMC 3424429. PMID 22933865.
- ↑ Mekinian A, Braun T, Decaux O, Falgarone G, Toussirot E, Raffray L; et al. (2014). “Inflammatory arthritis in patients with myelodysplastic syndromes: a multicenter retrospective study and literature review of 68 cases”. Medicine (Baltimore). 93 (1): 1–10. doi:10.1097/MD.0000000000000011. PMC 4616329. PMID 24378738.
Editor-In-Chief:
C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Eiman Ghaffarpasand, M.D. [2]