Polyarthritis
June 8th, 2021
Overview
Polyarthritis refers to inflammation affecting multiple joints (usually five or more). This may be symmetrical or asymmetrical, and may have a particular pattern of joint involvement.
Patterns of Involvement
- Symmetric polyarthritis: affects joints both sides in a symmetrical mannerRheumatoid arthritis, systemic lupus erythematosus
- Asymmetric polyarthritis: patchy joint involvementAnkylosing spondylitis, psoriatic arthritis, reactive arthritis, grout, pseudogout, septic arthritis
- Distal interphalangeal (DIP) involvementSuggests osteoarthritis
- MCP and PIP involvement with DIP sparingClassically rheumatoid arthritis
- Sacroiliac involvementSuggests spondyloarthropathy - ankylosing spondylitis or psoriatic arthritis
- Hip & knee involvementSuggests osteoarthritis
- Ankle involvementSuggests spondyloarthropathy - ankylosing spondylitis, psoriatic arthritis, reactive arthritis
- Metatarsophalangeal involvementClassically gout (involvement of this joint with gout is called podagra)
Causes of Polyarthritis
- Rheumatoid arthritis
- Seronegative spondyloarthropathies - reactive arthritis, ankylosing spondylitis, psoriatic arthritis, inflammatory bowel disease-related arthritis
- Crystal arthropathies - gout, pseudogout
- Osteoarthritis
- Connective tissue disease - systemic lupus erythematosus, mixed connective tissue disease
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