
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 local erythema
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 | Trauma[1] | + | – | – | – | – | + | Wound or laceration | – | – | Hemarthrosis | – | Severe joint effusion, Fracture | Fracture, Synovial tear | – | – | X-ray | Deformity, Severe pain | |
| Infection | Gonococcal infection[2] | + | + | – | – | – | + | 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[3] | + | + | – | – | – | + | 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 | ||
| Fungal infection[4] | – | +/- | – | – | – | +/- | Local eczema, Local erythema | Eosinophilia, Leukocytosis | ↑ | WBC counts range from 9,000-43,000/µL (PMNs predominance) | Direct microscopy | Joint effusion, Dislocation of the joint, Metaphyseal irregularities and punched out lesions | Articular erosion | – | Villonodular synovitis, Typical pannus, Non-caseating granulomas, Spherules containing coccidioidal endospores | Synovial histopathology | Malaise, Tenderness | ||
| Crystal-induced arthritis | Gout[5] | + | +/- | – | – | – | + | 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 | |
| Pseudo-gout[6] | + | – | – | – | – | +/- | Local swelling and erythema | Leukocytosis | ↑ | Rod shaped CPPD crystals, WBC count > 2000/µL | Hypercalcemia, Hypercalciuria | Radiodense lines paralleling the articular surface and calcification (chondrocalcinosis) | Calcific mass with a lobulated configuration in the ligamentum flavum or the joint capsule | Synovitis and calcific deposits in ultrasonography | Synovial calcium pyrophosphate crystals | Synovial fluid microscopy | Tenderness | ||
| Systemic disorders | Psoriatic arthritis[7] | + | – | – | – | – | + | Scaly erythematous plaques,
Guttate lesions, Lakes of pus, |
Normal | ↑ | High WBC count (5000-15,000/µL) with >50% of PMN leukocytes | ↑RF, ANA, IgA | Joint-space narrowing, Fluffy periostitis | Pencil-in-cup deformity, Early signs of synovitis | Sacroiliitic synovitis, Enthesitis in MRI | Lack of intrasynovial Ig and RF, Greater propensity for fibrous ankylosis, osseous resorption, and heterotopic bone formation | Clinical findings | Onycholysis, Splinter hemorrhages | |
| Inflammatory bowel disease-associated arthritis[8] | + | + | – | – | + | +/- | 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 | ||
References
- ↑ Punzi L, Galozzi P, Luisetto R, Favero M, Ramonda R, Oliviero F; et al. (2016). “Post-traumatic arthritis: overview on pathogenic mechanisms and role of inflammation”. RMD Open. 2 (2): e000279. doi:10.1136/rmdopen-2016-000279. PMC 5013366. PMID 27651925.
- ↑ 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.
- ↑ Cuéllar ML, Silveira LH, Espinoza LR (1992). “Fungal arthritis”. Ann Rheum Dis. 51 (5): 690–7. PMC 1005712. PMID 1616344.
- ↑ Reginato A, Paul H, Schumacher HR (September 1982). “Crystal-induced arthritis”. Arch Phys Med Rehabil. 63 (9): 401–8. PMID 6287963.
- ↑ Macmullan P, McCarthy G (2012). “Treatment and management of pseudogout: insights for the clinician”. Ther Adv Musculoskelet Dis. 4 (2): 121–31. doi:10.1177/1759720X11432559. PMC 3383522. PMID 22870500.
- ↑ Sankowski AJ, Lebkowska UM, CwikÅ‚a J, Walecka I, Walecki J (2013). “Psoriatic arthritis”. Pol J Radiol. 78 (1): 7–17. doi:10.12659/PJR.883763. PMC 3596149. PMID 23493653.
- ↑ Orchard TR (2012). “Management of arthritis in patients with inflammatory bowel disease”. Gastroenterol Hepatol (N Y). 8 (5): 327–9. PMC 3424429. PMID 22933865.
Editor-In-Chief:
C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Eiman Ghaffarpasand, M.D. [2]
