inflammatory arthritis
Jump to navigation
Jump to search
Etiology
- rheumatoid arthritis
- spondyloarthritis
- systemic lupus erythematosus
- infectious arthritis
- crystalline arthritis
Clinical manifestations
- morning stiffness > 60 minutes
- fever, fatigue, malaise
- erythema, warmth, soft tissue swelling, joint effusions
- reduced range of motion
Laboratory
- C-reactive protein in serum elevated
- erythrocyte sedimentation rate elevated
- complete blood count may show anemia of chronic inflammation
- synovial fluid analysis:
- WBC count > 2000 x10E9/uL
- neutrophil predominant with acute inflammation
- monocyte predominant with chronic inflammation
- WBC count > 2000 x10E9/uL
- troponin I in serum predicts excess cardiovascular mortality[1]
Differential diagnosis
- non-inflammatory arthritis
- morning stiffness < 30 minutes
- fever, fatigue, malaise generally absent
- minimal or no erythema, warmth, no soft tissue swelling
- joint effusions & reduced range of motion may occur with osteoarthritis
- synovial fluid analysis:
- C-reactive protein in serum & erythrocyte sedimentation rate normal or minimally elevated[2]
- acute monoarthritis on a background of well-controlled inflammatory arthritis suggests infectious arthritis
More general terms
References
- ↑ 1.0 1.1 Walsh N. Troponin Predicts Mortality in Inflammatory Arthritis. High levels associated with all-cause and cardiovascular death. MedPage Today. May 01, 2018 https://www.medpagetoday.com/meetingcoverage/bsr/72632
Skeoch S, et al The association of high sensitivity troponin levels with subsequent cardiovascular mortality in an inflammatory arthritis cohort: Results from the Norfolk arthritis register. British Society for Rheumatology (BSR) 2018; Abstract O10. - ↑ 2.0 2.1 Medical Knowledge Self Assessment Program (MKSAP) 19 American College of Physicians, Philadelphia 2022