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Arthritis

Arthritis is inflammation of one or more joints. There are two major categories of arthritis.


Monoarticular Arthritis

Most common diagnoses in acute monoarticular arthritis: crystalline, septic

Most important diagnostic test in acute monoarticular arthritis: synovial fluid analysis and culture.

Most important diagnoses to rule out in chronic monoarticular arthritis: indolent infection, tumor.

Best diagnostic tests in chronic monoarticular arthritis: synovial fluid analysis, radiography, magnetic resonance imaging, arthroscopy with synovial biopsy and culture.

Diseases that Commonly Present with Monoarthritis

Septic diseases, Bacterial, Mycobacterial, Lyme disease, Fungal, Crystal deposition diseases, Gout, Calcium pyrophosphate dihydrate deposition disease (pseudogout), Hydroxyapatite deposition disease, Calcium oxalate deposition disease, Traumatic, Fracture, Internal derangement, Hemarthrosis, Other diseases, Juvenile idiopathic arthritis, Coagulopathy, Avascular necrosis of bone, Foreign-body synovitis, Pigmented villonodular synovitis, Palindromic rheumatism

Inflammatory and Noninflammatory Causes of Chronic Monoarthritis

INFLAMMATORY

NONINFLAMMATORY

Mycobacterial infection

Osteoarthritis

Fungal infection

Internal derangement of the knee

Lyme arthritis

Avascular necrosis of bone

Monoarticular presentation of rheumatoid arthritis

Pigmented villonodular synovitis

Seronegative spondyloarthropathies

Synovial chondromatosis

Sarcoid arthritis

Synovioma

Foreign-body synovitis

Polyarticular Arthritis

INFECTION

OTHER INFLAMMATORY CONDITIONS

Gonococcal

Rheumatoid arthritis

Meningococcal

Polyarticular and systemic JIA

Lyme

Acute sarcoid arthritis

Acute rheumatic fever

Systemic lupus erythematosus

Infective endocarditis

Reactive arthritis

Viral (especially rubella, hepatitis B and C, parvovirus, Epstein–Barr, HIV)

Psoriatic arthritis

Polyarticular gout

Distribution of Joint Involvement in Polyarthritis

DISEASE

JOINTS COMMONLY INVOLVED

JOINTS COMMONLY SPARED

Gonococcal arthritis

Knee, wrist, ankle, hand IP

Axial

Lyme arthritis

Knee, shoulder, wrist, elbow

Axial

Rheumatoid arthritis

Wrist, MCP, PIP, elbow, glenohumeral, cervical spine, hip, knee, ankle, tarsal, MTP

DIP, thoracolumbar spine

Osteoarthritis

First CMC, DIP, PIP, cervical spine, thoracolumbar spine, hip, knee, first MTP, toe IP

MCP, wrist, elbow, gleno-shoulder, ankle, tarsal

Reactive arthritis

Knee, ankle, tarsal, MTP, first toe IP, elbow, axial

Hip

Psoriatic arthritis

Knee, ankle, MTP, first toe IP, wrist, MCP, hand IP, axial

Enteropathic arthritis

Knee, ankle, elbow, shoulder, MCP, PIP, wrist, axial

Polyarticular gout

First MTP, instep, heel, ankle, knee

Axial

CPPD disease

Knee, wrist, shoulder, ankle, MCP, hand IP, hip, elbow

Axial

Sarcoid arthritis

Ankle, knee

Axial

Hemochromatosis

MCP, wrist, ankle, knee, hip, feet, shoulder

CMC, Carpometacarpal; DIP, distal interphalangeal; IP, Interphalangeal; MCP, metacarpophalangeal; MTP, metatarsophalangeal. PIP, proximal interphalangeal;

Synovial Fluid Analysis

normal

Noninflammatory

Inflammatory

Septic

Hemorrhagic

Color

clear

clear

turbid

turbid

bloody

Viscosity

high

high

low

various

various

wbc/mm3

<200

≤2000

>2000

>50000

Various

PMN (%)

<25

≤25

>25

>50

various

wbc/mm3 = Granulocytes/mm3, PMN = polymorphonuclear leukocytes


Pubmed

UpToDate

Images


Videos:

Arthritis / Arthrose - Teil 1

Arthritis / Arthrose - Teil 2


Web:

Physical Activity for Arthritis - CDC

Mayoclinic

Arthritis Foundation



Intermittentent Arthritis

Periodic Syndormes

Intermittent hydrarthrosis

Palindormer Rheumatismus

FMF

Hyperimmunglobulin D und periodisches Fieber

RS3PE

"Tietze"

Kristallarhtritiden: Gicht CPPD Hydroxyapatit

Sarkoidose

SpA

Infektionen: Lyme Whipple

Mechanisch: Meniskusriss Gelenkskörpe


Arhtritis mutilans

Psoriasis

RA

Gicht

MRH


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