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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.

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Polyarthritis with morning stiffness

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
Polyarthritis Other seronegative spondyloarthritides Ankylosing spondylitis[1] + – +/- +/- + – Dactylitis (sausage digit) Normocytic normochromic anemia ↑  High WBC count (lymphocyte predominance) ↑Alkaline phosphatase (ALP) Bony erosions and sclerosis of the joints  Early sacroiliitis, erosions, and enthesitis Possible cauda equina syndrome secondary to spinal stenosis in MRI Chronic inflammation with CD4+ and CD8+ T lymphocytes and macrophages Plain x-rays Peripheral enthesitis, Uveitis 
Inflammatory bowel disease[2] + + – – + +/- Pyoderma gangrenosum (ulcerative colitis), Erythema nodosum (Crohn disease) Iron deficiency anemia, Leukocytosis, Thrombocytosis ↑ Mild to moderate inflammatory fluid, PMN predominance ↑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
Rheumatoid arthritis[3] + – + + + – Rheumatoid nodules Anemia, Thrombocytosis ↑ WBC count >2000/µL (generally 5000-50,000/µL), with neutrophil predominance (60-80%) Anti-CCP Ab, Hyperuricemia Joint-space narrowing Microfractures Synovitis in MRI Influx of inflammatory cells into the synovial membrane, with angiogenesis Clinical findings coupled anti-CCP antibody Rheumatoid nodules
Systemic rheumatic illnesses Still’s disease[4] – – +/- – +/- + Mild papules and nodules Anemia, Thrombocytosis ↑ High WBC count (5000-15,000/µL) with >50% of PMN leukocytes ANA, RF Soft tissue swelling,

Osteopenia,

Joint-space narrowing

Synovial inflammation Inflamed synovium in ultrasonography Inflammatory infiltration in synovium Clinical findings and synovial fluid analysis Ocular involvement
Other systemic illnesses Palindromic rheumatism[5] + – – +/- + – Rheumatoid nodules Anemia ↑ High WBC count (5000-15,000/µL) with >50% of PMN leukocytes RF, Anti-CCP antibody, ↑Cr or BUN,

↑ALT or AST, ANA

Effusions in joints Microfractures Basilar invagination with cranial migration of an eroded odontoid peg in MRI Influx of inflammatory cells into the synovial membrane, withangiogenesis, proliferation of chronic inflammatory cells Clinical findings coupled anti-CCP antibody Rheumatoid nodules
Polyarticular pain Fibromyalgia[6] – – – +/- +/- – Maculopapular rash Normal – Normal – – – – Mild inflammation Clinical findings Muscle pain

References

  1. ↑ McVeigh CM, Cairns AP (2006). “Diagnosis and management of ankylosing spondylitis”. BMJ. 333 (7568): 581–5. doi:10.1136/bmj.38954.689583.DE. PMC 1570004. PMID 16974012.
  2. ↑ Orchard TR (2012). “Management of arthritis in patients with inflammatory bowel disease”. Gastroenterol Hepatol (N Y). 8 (5): 327–9. PMC 3424429. PMID 22933865.
  3. ↑ Heidari B (2011). “Rheumatoid Arthritis: Early diagnosis and treatment outcomes”. Caspian J Intern Med. 2 (1): 161–70. PMC 3766928. PMID 24024009.
  4. ↑ Kadavath S, Efthimiou P (February 2015). “Adult-onset Still’s disease-pathogenesis, clinical manifestations, and new treatment options”. Ann. Med. 47 (1): 6–14. doi:10.3109/07853890.2014.971052. PMID 25613167.
  5. ↑ Iyer VR, Cohen GL (February 2011). “Palindromic rheumatism”. South. Med. J. 104 (2): 147–9. doi:10.1097/SMJ.0b013e318200c4cc. PMID 21206416.
  6. ↑ Bellato E, Marini E, Castoldi F, Barbasetti N, Mattei L, Bonasia DE; et al. (2012). “Fibromyalgia syndrome: etiology, pathogenesis, diagnosis, and treatment”. Pain Res Treat. 2012: 426130. doi:10.1155/2012/426130. PMC 3503476. PMID 23213512.

Editor-In-Chief:
C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Eiman Ghaffarpasand, M.D. [2]