infectious%20arthritis
INFECTIOUS ARTHRITIS
The classical presentation of infectious arthritis is acute onset of pain, warmth and swelling of a single joint.
The range of motion is usually decreased.
The knee is the most commonly affected but any joint may be involved.
Fever and chills may be present.
More than 1 joint may be involved in patients with pre-existing joint disease, other inflammatory conditions or severe sepsis, and in some patients infected with certain pathogens eg N gonorrheae, N meningitidis and Salmonella spp.
Infectious arthritis must always be a part of the differential diagnosis in a patient with an acute monoarthritis. 

Differential Diagnosis

  • Crystal-induced arthritis (eg gout & pseudogout)
    • Recurrent monoarthritis, podagra & tophi are highly predictive of gout
    • Definitive diagnosis is through demonstration of characteristic urate crystals in the synovial fluid
    • Crystal-induced arthritis & infectious arthritis may co-exist
  • Exacerbations of rheumatoid arthritis & osteoarthritis
  • Chronic inflammatory diseases (eg Reiter’s syndrome, ankylosing spondylitis, inflammatory bowel disease-associated arthritis, collagen vascular disease & spondyloarthritis)
  • Osteomyelitis
  • Lyme disease
    • Arthritis develops weeks-months after the rash & fever of Lyme disease
    • Confirmation is done via Western blot
  • Rheumatic fever
  • Reactive arthritis from bacterial, viral or parasitic infections
  • Bursitis/cellulitis
  • Trauma, hemarthrosis, neuropathic arthropathy
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