monoarticular arthritis

Introduction

Arthritis involving a single joint.

Etiology

• osteoarthritis (also oligoarticular)
• infectious arthritis (also oligoarticular)
  • acute: see infectious arthritis
  • chronic: mycobacterial, fungal, Lyme disease (see infectious arthritis)
• crystalline arthritis
  • gout
  • CPPD (also oligoarticular)
  • hydroxyapatite deposition disease
• trauma
• osteonecrosis (avascular osteonecrosis)
• tumor
• hemarthrosis
• early connective tissue disease

Clinical manifestations

• see arthritis

Laboratory

• if acute, joint aspiration with synovial fluid analysis
  • gram stain, culture, crystal analysis
  • rule out/in infectious arthritis, crystalline arthritis
  • gram stain negative in 20% of septic arthritis, especially common with gram-negative organisms
• also see arthritis

Radiology

• see arthritis

Differential diagnosis

• chronic inflammatory monoarticular arthritis suggests infectious arthritis
  • tuberculous arthritis
  • fungal arthritis
  • Lyme arthritis

Management

• empiric antibiotic therapy while awaiting culture results
  • ceftriaxone & vancomycin
• see arthritis

Prognosis

• most cases resolve within 2 years
• 1/4 of cases evolve into rheumatoid arthritis, psoriatic arthritis or other inflammatory arthritis

More general terms

• arthritis