Polyarthritis: Difference between revisions

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Latest revision as of 14:53, 30 May 2018

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Eiman Ghaffarpasand, M.D. [2]

Differential Diagnosis of Diseases That Cause Polyarthritis

Differentiating the diseases that can cause polyarthritis:

To review the differential diagnosis of polyarthritis with joint swelling, click here.

To review the differential diagnosis of polyarthritis with fever, click here.

To review the differential diagnosis of polyarthritis with weight loss, click here.

To review the differential diagnosis of polyarthritis with claudication, click here.

To review the differential diagnosis of polyarthritis with morning stiffness, click here.

To review the differential diagnosis of polyarthritis with local erythema, click here.

To review the differential diagnosis of polyarthritis with joint swelling and fever, click here.

To review the differential diagnosis of polyarthritis with joint swelling, fever, and weight loss, click here.

			Symptoms				Physical examination			Lab Findings				Imaging			Histopathology
Diseases			Clinical manifestations							Para-clinical findings								Gold standard	Additional findings
			Symptoms				Physical examination			Para-clinical findings
			Joint Swelling	Fever	Weight loss	Claudication	Morning stiffness	Local erythema	Skin manifestation	CBC	ESR	Synovial fluid	Other	X-ray	CT scan	Other	Histopathology
Polyarthritis	Infectious arthritis	Lyme disease^[1]	+	+	+/-	+/-	-	-	Erythema migrans	Leukopenia, Thrombocytopenia	-	Cell counts 500-98,000/µL	Microscopic hematuria, proteinuria, ↑ALT or AST	Knee joint effusion, erosion and permanent damage, enthesopathy	-	-	Fibrosis of the deeper dermis and hyalinization of collagen bundles	Serologic tests	Third degree heart block
	Infectious arthritis	Bacterial endocarditis^[2]	+	+	+	-	-	+/-	Janeway lesions, Osler nodes, Roth spots	Normochromic-normocytic anemia	↑	↑WBC, S. aureus in culture	Hyperglobulinemia, Cryoglobulinemia	Joint erosion and effusion	-	-	Vegetation or intracardiac abscess demonstrating active endocarditis	Echocardiography (TTE)	Vertebral osteomyelitis
	Postinfectious arthritis	Rheumatic fever^[3]	+	+	-	-	-	+/-	Erythema marginatum rheumaticum	Leukocytosis	↑	Sterile inflammatory reaction with cells < 20,000/μL	Streptococcal antibody titer	Cardiomegaly	Valvular or pericardial calcification	Echocardiographic changes in heart valves	Edema, fibrinoid necrosis, mononuclear cell infiltrate	Echocardiography	Sydenham's chorea, carditis
		Reactive arthritis^[4]	+/-	+/-	-	-	-	-	Genital ulceration	Normocytic normochromic anemia	↑	High WBC count (10,000-40,000/µL)	HLA-B27 test	Periosteal reaction and proliferation of tendon insertion site	Sacroiliitis	Enthesitis in ultrasonography	Keratoderma blennorrhagicum, balanitis circinata	Spondyloarthritis and unequivocal demonstration of preceding infection	Conjunctivitis, uveitis
		Enteric infection^[5]	-	+	-	-	-	-	Keratoderma and psoriaform lesions, erythema nodosum	Neutrophilia	↑	PCR of causative organism	Stool exam and culture	-	-	-	Neutrophilic infiltration in synovial tissues	PCR of causative organism in synovial fluid	Diarrhea, enthesopathy
	Other seronegative spondyloarthritides	Ankylosing spondylitis^[6]	+	-	+/-	+/-	+	-	Dactylitis (sausage digit)	Normocytic normochromic anemia	↑	High WBC count (lymphocyte predominance)	↑Alkaline phosphatase (ALP)	Bony erosions and sclerosis of the joints	Early sacroiliitis, erosions, and enthesitis	Possible cauda equina syndrome secondary to spinal stenosis in MRI	Chronic inflammation with CD4⁺ and CD8⁺ T lymphocytes and macrophages	Plain x-rays	Peripheral enthesitis, uveitis
		Psoriatic arthritis^[7]	+	-	-	-	-	+	Scaly erythematous plaques, guttate lesions, lakes of pus, Erythroderma	Normal	↑	High WBC count (5000-15,000/µL) with >50% of PMN leukocytes	↑RF, ANA, IgA	Joint-space narrowing, fluffy periostitis	Pencil-in-cup deformity, early signs of synovitis	Sacroiliitic synovitis, enthesitis in MRI	Lack of intrasynovial Ig and RF, greater propensity for fibrous ankylosis, osseous resorption, and heterotopic bone formation	Clinical findings	Onycholysis, splinter hemorrhages
		Inflammatory bowel disease^[8]	+	+	-	-	+	+/-	Pyoderma gangrenosum (ulcerative colitis), erythema nodosum (Crohn disease)	Iron deficiency anemia, leukocytosis, thrombocytosis	↑	Mild to moderate inflammatory fluid, PMN predominance	↑RF, anti-endomysial Ab, anti-transglutaminase Ab	Bilateral sacroiliitis, syndesmophytes and apophyseal joint involvement in spine	-	Early detection of spinal and sacroiliac lesions in MRI	-	Clinical findings and history	Acute anterior uveitis
	Rheumatoid arthritis^[9]		+	-	+	+	+	-	Rheumatoid nodules	Anemia, thrombocytosis	↑	WBC count >2000/µL (generally 5000-50,000/µL), with neutrophil predominance (60-80%)	Anti-CCP Ab, hyperuricemia	Joint-space narrowing	Microfractures	Synovitis in MRI	Influx of inflammatory cells into the synovial membrane, with angiogenesis	Clinical findings coupled anti-CCP antibody	Rheumatoid nodules
	Crystal-induced arthritis^[10]		+	+/-	-	-	-	+	Joint erythema	Leukocytosis	↑	Needle shaped urate crystals, WBC count > 2000/µL	Urinary uric acid (>1100 mg in 24h)	Punched-out erosions or lytic areas with overhanging edges	Complementary for recognizing erosions	Tophi or edema in MRI	Large pale pink acellular areas (urate crystals), surrounded by histiocytes and multinucleated giant cells	Synovial fluid assay	Conjunctival nodules
	Systemic rheumatic illnesses	Systemic lupus erythematosus^[11]	+	-	+/-	-	-	+	Malar rash, photosensitivity, discoid lupus	Leukopenia, lymphopenia, anemia, thrombocytopenia	↑	Cell count from < 25% PMNs (non-inflammatory effusions) to > 50% PMNs (inflammatory effusions)	Creatine kinase, LFT, ANA, anti-dsDNA Ab, Anti-Smith Ab, lupus anticoagulant	Periarticular osteopenia and soft-tissue swelling without erosions	Interstitial lung disease, pneumonitis, pulmonary emboli, alveolar hemorrhage	Pericardial effusion, pulmonary hypertension, verrucous Libman-Sacks endocarditis on echocardiography	Inflammatory infiltrates at the dermoepidermal junction and vacuolar change in the basal columnar cells	Anti-dsDNA antibody	Rheumatoid arthritis, serositis, oral ulcers
		Systemic vasculitis^[12]	-	-	+/-	+	-	-	Petechia, purpura	Anemia, thrombocytosis	↑	-	P-ANCA, C-ANCA , ANA	Soft tissue swelling with mild erosions	Focal regions of infarction or hemorrhage	Multiple microaneurysms,hemorrhage due to focal rupture, occlusion in angiography	Acute destruction of the media by neutrophils, with loss of elastic fibers	Angiography	Peripheral neuropathy, livedo reticularis
		Systemic sclerosis^[13]	-	-	+/-	-	-	-	3 phases of skin manifestation: Edematous, indurative, and atrophic	Thrombocytopenia	↑	Cell count < 25% PMNs (non-inflammatory)	Hypergammaglobulinemia, Creatine phosphokinase	Juxta-articular osteoporosis, joint space narrowing, frank erosions	Synovial inflammation	Synovial vascularity in doppler ultrasonography	Epidermal skin appendages atrophy, broad and hyalinized collagen fibers in the reticular dermis	Histopathology	Raynaud phenomenon, Tendon friction rubs
		Polymyositis/dermatomyositis^[14]	-	-	+/-	-	-	+	Heliotrope rash, Gottron papules, poikiloderma	Normocytic normochromic anemia	↑	Predominantly mononuclear cells and large macrophage-like cells	Anti–Mi-2 antibodies, anti–Jo-1 antibodies, creatine kinase, ANA	Marginal erosions and periarticular calcification	-	-	Vacuolar changes of the columnar epithelium and lymphocytic infiltrates	Muscle biopsy	Dysphagia
		Still's disease^[15]	-	-	+/-	-	+/-	+	Mild papules and nodules	Anemia, thrombocytosis	↑	High WBC count (5000-15,000/µL) with >50% of PMN leukocytes	ANA, RF	Soft tissue swelling, osteopenia, joint-space narrowing	Synovial inflammation	Inflamed synovium in ultrasonography	Inflammatory infiltration in synovium	Clinical findings and synovial fluid analysis	Ocular involvement
		Behçet's syndrome^[16]	+	-	-	-	-	-	Erythema nodosum	Normocytic normochromic anemia	↑	Cell count < 25% PMNs (non-inflammatory)	Serum complement levels, human leukocyte antigen (HLA)-B51	Soft tissue swelling	Non-erosive synovitis	-	Dermal vessels infiltration with lymphocytes and plasma cells, immune deposits of immunoglobulin M (IgM) and C3	Clinical findings	Oral ulcer, mucosal erosion
		Relapsing polychondritis^[17]	+	-	-	-	-	-	-	Leukocytosis, anemia	-	Cell count < 25% PMNs (non-inflammatory)	Cryoglobulins, ANA, C-ANCA	Tracheal stenosis in CXR	Calcification of cartilaginous structures	Aortic root dilatation and degree of aortic regurgitation in echocardiography	Chondrolysis, chondritis, Perichondritis	Clinical findings coupled with imaging	Ear pain and redness
	Other systemic illnesses	Sarcoidosis^[18]	+	-	-	-	-	-	Mild papules and nodules	Mild anemia	↑	Cell count < 25% PMNs (non-inflammatory)	IL-2 and IFN-γ, ↑ ACE, ↑ 1, 25-dihydroxyvitamin D	Bilateral hilar adenopathy	Active alveolitis or fibrosis	Hepatosplenomegaly in ultrasonography	Noncaseating granulomas (NCGs)	Histological confirmation	Heart block, ocular lesion
		Palindromic rheumatism^[19]	+	-	-	+/-	+	-	Rheumatoid nodules	Anemia	↑	High WBC count (5000-15,000/µL) with >50% of PMN leukocytes	RF, Anti-CCP antibody, ↑Cr or BUN, ↑ALT and/or AST, ANA	Effusions in joints	Microfractures	Basilar invagination with cranial migration of an eroded odontoid peg in MRI	Influx of inflammatory cells into the synovial membrane, withangiogenesis, proliferation of chronic inflammatory cells	Clinical findings coupled anti-CCP antibody	Rheumatoid nodules
		Familial Mediterranean fever^[20]	-	+	-	-	-	-	A well-demarcated, erythematous, warm rash, particularly below the knee	Leukocytosis	↑	Cell counts as high as 100,000/µL	CRP, amyloid A protein, fibrinogen	Synovial effusions	Pleural effusions	Air-fluid levels in MRI	Massive amyloid infiltration of the blood vessels and endothelial side of the glomerular basement membrane	Clinical findings	Abdominal pain, Severe myalgia, scrotal attacks
		Hyperlipoproteinemias^[21]	-	-	-	-	-	-	Xanthelasma	Leukocytosis	↑	Xanthochromic fluid with mononuclear cells predominance	CRP, Hyperlipidemia	Joint space narrowing	Achilles tendon enthesitis	Retrocalcaneal bursitis and ill-defined edema in posterosuperior corner of the calcaneus	Inflammatory infiltration	Laboratory findings	Atherosclerosis
Polyarticular pain	Viral arthritis	Hepatitis B and C^[22]	-	+	+	-	-	-	Urticarial and maculopapular eruptions	Leukocytosis	↑	Cell counts < 100,000/µL	LFT, HBsAg	Joint space narrowing	-	-	Deposition of immune complexes, cryoprecipitates containing HBsAg and complements	HBsAg	Liver failure, icterus
		Rubella^[23]	-	+	+/-	-	-	-	Acute maculopapular rash	Leukocytosis	↑	Rubella virus antigen	LFT, CRP	Joint space narrowing	-	-	Proliferation of the synovial lining cells, without inflammatory cells	Serological evidence	Headache, malaise, mimics rheumatoid arthritis
		Parvovirus^[24]	+	+	+/-	-	-	-	Fifth disease/ erythema infectiosum	Aplastic crisis	↑	Normal	ANA, RF, CRP	Joint swelling	-	-	Immune complex deposition	Parvovirus IgM antibody	Transient aplastic crisis, fetal infection
	Fibromyalgia^[25]		-	-	-	+/-	+/-	-	Maculopapular rash	Normal	-	Normal	-	-	-	-	Mild inflammation	Clinical findings	Muscle pain
	Soft tissue abnormalities		+	-	-	-	-	+/-	Maculopapular rash	Normal	-	Cell count < 25% PMNs (non-inflammatory)	CRP, Ca	Joint swelling	Synovial edema and thickness	Mild joint effusion in ultrasonography	Mild inflammation	Clinical findings	Mucositis, enthesitis
	Hypothyroidism^[26]		-	-	-	-	-	-	Dry and coarse skin	Anemia	-	Clear yellow fluid with normal cell counts	TSH, T4, T3	Peri-articular demineralization	Destructive changes in the cartilage and bone	High-signal fluid in the joint space in MRI	Physeal growth plate with little evidence of cartilage cellular proliferation	TSH, T4, T3	Decreased DTR, fatigue
	Neuropathic pain^[27]		-	-	-	-	-	-	Livedo reticularis	Normal	-	Normal	Hyperglycemia, hypokalemia, hypocalcemia	-	-	-	-	Neurologic examination	Paresthesia, dysesthesia
	Metabolic bone disease^[28]		-	-	-	-	-	-	Hyperpigmentation	Mild anemia	↑	Cell count < 25% PMNs (non-inflammatory)	Vitamin D, PTH	Peri-articular demineralization	Microfractures	Subperiosteal reaction	Decrease mineralization of bone matrix	Laboratory findings	Bone pain, constipation
	Depression^[29]		-	-	+	-	-	-	-	Normal	-	Normal	Normal	-	-	-	-	Psychological interview	Slow psychomotor, muscle pain

References

↑ Lantos PM (2015). "Chronic Lyme disease". Infect Dis Clin North Am. 29 (2): 325–40. doi:10.1016/j.idc.2015.02.006. PMC 4477530. PMID 25999227.
↑ Soor P, Sharma N, Rao C (2017). "Multifocal Septic Arthritis Secondary to Infective Endocarditis: A Rare Case Report". J Orthop Case Rep. 7 (1): 65–68. doi:10.13107/jocr.2250-0685.692. PMC 5458702. PMID 28630844.
↑ Kumar RK, Tandon R (2013). "Rheumatic fever & rheumatic heart disease: the last 50 years". Indian J Med Res. 137 (4): 643–58. PMC 3724245. PMID 23703332.
↑ Colmegna I, Cuchacovich R, Espinoza LR (2004). "HLA-B27-associated reactive arthritis: pathogenetic and clinical considerations". Clin Microbiol Rev. 17 (2): 348–69. PMC 387405. PMID 15084505.
↑ Hill Gaston, J (2003). "Arthritis associated with enteric infection". Best Practice & Research Clinical Rheumatology. 17 (2): 219–239. doi:10.1016/S1521-6942(02)00104-3. ISSN 1521-6942.
↑ McVeigh CM, Cairns AP (2006). "Diagnosis and management of ankylosing spondylitis". BMJ. 333 (7568): 581–5. doi:10.1136/bmj.38954.689583.DE. PMC 1570004. PMID 16974012.
↑ Sankowski AJ, Lebkowska UM, Cwikła J, Walecka I, Walecki J (2013). "Psoriatic arthritis". Pol J Radiol. 78 (1): 7–17. doi:10.12659/PJR.883763. PMC 3596149. PMID 23493653.
↑ Orchard TR (2012). "Management of arthritis in patients with inflammatory bowel disease". Gastroenterol Hepatol (N Y). 8 (5): 327–9. PMC 3424429. PMID 22933865.
↑ Heidari B (2011). "Rheumatoid Arthritis: Early diagnosis and treatment outcomes". Caspian J Intern Med. 2 (1): 161–70. PMC 3766928. PMID 24024009.
↑ Reginato A, Paul H, Schumacher HR (September 1982). "Crystal-induced arthritis". Arch Phys Med Rehabil. 63 (9): 401–8. PMID 6287963.
↑ Manson JJ, Rahman A (2006). "Systemic lupus erythematosus". Orphanet J Rare Dis. 1: 6. doi:10.1186/1750-1172-1-6. PMC 1459118. PMID 16722594.
↑ Watts RA, Scott DG (October 2016). "Vasculitis and inflammatory arthritis". Best Pract Res Clin Rheumatol. 30 (5): 916–931. doi:10.1016/j.berh.2016.10.008. PMID 27964796.
↑ Avouac, J.; Clements, P. J.; Khanna, D.; Furst, D. E.; Allanore, Y. (2012). "Articular involvement in systemic sclerosis". Rheumatology. 51 (8): 1347–1356. doi:10.1093/rheumatology/kes041. ISSN 1462-0324.
↑ Briemberg HR, Amato AA (September 2003). "Dermatomyositis and Polymyositis". Curr Treat Options Neurol. 5 (5): 349–356. PMID 12895397.
↑ Kadavath S, Efthimiou P (February 2015). "Adult-onset Still's disease-pathogenesis, clinical manifestations, and new treatment options". Ann. Med. 47 (1): 6–14. doi:10.3109/07853890.2014.971052. PMID 25613167.
↑ Sugawara S, Ehara S, Hitachi S, Sugimoto H (March 2010). "Hand and wrist arthritis of Behçet disease: imaging features". Acta Radiol. 51 (2): 183–6. doi:10.3109/02841850903401349. PMID 20121672.
↑ Emmungil H, Aydın SZ (2015). "Relapsing polychondritis". Eur J Rheumatol. 2 (4): 155–159. doi:10.5152/eurjrheum.2015.0036. PMC 5047229. PMID 27708954.
↑ Iannuzzi MC, Rybicki BA, Teirstein AS (November 2007). "Sarcoidosis". N. Engl. J. Med. 357 (21): 2153–65. doi:10.1056/NEJMra071714. PMID 18032765.
↑ Iyer VR, Cohen GL (February 2011). "Palindromic rheumatism". South. Med. J. 104 (2): 147–9. doi:10.1097/SMJ.0b013e318200c4cc. PMID 21206416.
↑ Yildirim K, Uzkeser H, Uyanik A, Karatay S, Kiziltunc A (2011). "Trace element levels in patients with familial mediterranean Fever". Eurasian J Med. 43 (2): 79–82. doi:10.5152/eajm.2011.18. PMC 4261345. PMID 25610168.
↑ Soubrier, Martin; Dubost, Jean Jacques; Thiéblot, Philippe; Ristori, Jean Michel (2009). "Oligo-arthritis and type IV hyperlipoproteinemia". Joint Bone Spine. 76 (1): 95–97. doi:10.1016/j.jbspin.2008.03.009. ISSN 1297-319X.
↑ Ganem, Don; Prince, Alfred M. (2004). "Hepatitis B Virus Infection — Natural History and Clinical Consequences". New England Journal of Medicine. 350 (11): 1118–1129. doi:10.1056/NEJMra031087. ISSN 0028-4793.
↑ Spruance SL, Metcalf R, Smith CB, Griffiths MM, Ward JR (March 1977). "Chronic arthropathy associated with rubella vaccination". Arthritis Rheum. 20 (2): 741–7. PMID 849368.
↑ Moore TL (July 2000). "Parvovirus-associated arthritis". Curr Opin Rheumatol. 12 (4): 289–94. PMID 10910181.
↑ Bellato E, Marini E, Castoldi F, Barbasetti N, Mattei L, Bonasia DE; et al. (2012). "Fibromyalgia syndrome: etiology, pathogenesis, diagnosis, and treatment". Pain Res Treat. 2012: 426130. doi:10.1155/2012/426130. PMC 3503476. PMID 23213512.
↑ McLean RM, Podell DN (February 1995). "Bone and joint manifestations of hypothyroidism". Semin. Arthritis Rheum. 24 (4): 282–90. PMID 7740308.
↑ Magrinelli F, Zanette G, Tamburin S (October 2013). "Neuropathic pain: diagnosis and treatment". Pract Neurol. 13 (5): 292–307. doi:10.1136/practneurol-2013-000536. PMID 23592730.
↑ Skowrońska-Jóźwiak E, Lorenc RS (2006). "Metabolic bone disease in children : etiology and treatment options". Treat Endocrinol. 5 (5): 297–318. PMID 17002489.
↑ Trivedi MH (2004). "The link between depression and physical symptoms". Prim Care Companion J Clin Psychiatry. 6 (Suppl 1): 12–6. PMC 486942. PMID 16001092.

Template:WH Template:WS

[pmid25999227-1] Lantos PM (2015). "Chronic Lyme disease". Infect Dis Clin North Am. 29 (2): 325–40. doi:10.1016/j.idc.2015.02.006. PMC 4477530. PMID 25999227.

[pmid28630844-2] Soor P, Sharma N, Rao C (2017). "Multifocal Septic Arthritis Secondary to Infective Endocarditis: A Rare Case Report". J Orthop Case Rep. 7 (1): 65–68. doi:10.13107/jocr.2250-0685.692. PMC 5458702. PMID 28630844.

[pmid23703332-3] Kumar RK, Tandon R (2013). "Rheumatic fever & rheumatic heart disease: the last 50 years". Indian J Med Res. 137 (4): 643–58. PMC 3724245. PMID 23703332.

[pmid15084505-4] Colmegna I, Cuchacovich R, Espinoza LR (2004). "HLA-B27-associated reactive arthritis: pathogenetic and clinical considerations". Clin Microbiol Rev. 17 (2): 348–69. PMC 387405. PMID 15084505.

[Hill_Gaston2003-5] Hill Gaston, J (2003). "Arthritis associated with enteric infection". Best Practice & Research Clinical Rheumatology. 17 (2): 219–239. doi:10.1016/S1521-6942(02)00104-3. ISSN 1521-6942.

[pmid16974012-6] McVeigh CM, Cairns AP (2006). "Diagnosis and management of ankylosing spondylitis". BMJ. 333 (7568): 581–5. doi:10.1136/bmj.38954.689583.DE. PMC 1570004. PMID 16974012.

[pmid23493653-7] Sankowski AJ, Lebkowska UM, Cwikła J, Walecka I, Walecki J (2013). "Psoriatic arthritis". Pol J Radiol. 78 (1): 7–17. doi:10.12659/PJR.883763. PMC 3596149. PMID 23493653.

[pmid22933865-8] Orchard TR (2012). "Management of arthritis in patients with inflammatory bowel disease". Gastroenterol Hepatol (N Y). 8 (5): 327–9. PMC 3424429. PMID 22933865.

[pmid24024009-9] Heidari B (2011). "Rheumatoid Arthritis: Early diagnosis and treatment outcomes". Caspian J Intern Med. 2 (1): 161–70. PMC 3766928. PMID 24024009.

[pmid62879632-10] Reginato A, Paul H, Schumacher HR (September 1982). "Crystal-induced arthritis". Arch Phys Med Rehabil. 63 (9): 401–8. PMID 6287963.

[pmid16722594-11] Manson JJ, Rahman A (2006). "Systemic lupus erythematosus". Orphanet J Rare Dis. 1: 6. doi:10.1186/1750-1172-1-6. PMC 1459118. PMID 16722594.

[pmid27964796-12] Watts RA, Scott DG (October 2016). "Vasculitis and inflammatory arthritis". Best Pract Res Clin Rheumatol. 30 (5): 916–931. doi:10.1016/j.berh.2016.10.008. PMID 27964796.

[AvouacClements2012-13] Avouac, J.; Clements, P. J.; Khanna, D.; Furst, D. E.; Allanore, Y. (2012). "Articular involvement in systemic sclerosis". Rheumatology. 51 (8): 1347–1356. doi:10.1093/rheumatology/kes041. ISSN 1462-0324.

[pmid12895397-14] Briemberg HR, Amato AA (September 2003). "Dermatomyositis and Polymyositis". Curr Treat Options Neurol. 5 (5): 349–356. PMID 12895397.

[pmid25613167-15] Kadavath S, Efthimiou P (February 2015). "Adult-onset Still's disease-pathogenesis, clinical manifestations, and new treatment options". Ann. Med. 47 (1): 6–14. doi:10.3109/07853890.2014.971052. PMID 25613167.

[pmid20121672-16] Sugawara S, Ehara S, Hitachi S, Sugimoto H (March 2010). "Hand and wrist arthritis of Behçet disease: imaging features". Acta Radiol. 51 (2): 183–6. doi:10.3109/02841850903401349. PMID 20121672.

[pmid27708954-17] Emmungil H, Aydın SZ (2015). "Relapsing polychondritis". Eur J Rheumatol. 2 (4): 155–159. doi:10.5152/eurjrheum.2015.0036. PMC 5047229. PMID 27708954.

[pmid18032765-18] Iannuzzi MC, Rybicki BA, Teirstein AS (November 2007). "Sarcoidosis". N. Engl. J. Med. 357 (21): 2153–65. doi:10.1056/NEJMra071714. PMID 18032765.

[pmid21206416-19] Iyer VR, Cohen GL (February 2011). "Palindromic rheumatism". South. Med. J. 104 (2): 147–9. doi:10.1097/SMJ.0b013e318200c4cc. PMID 21206416.

[pmid25610168-20] Yildirim K, Uzkeser H, Uyanik A, Karatay S, Kiziltunc A (2011). "Trace element levels in patients with familial mediterranean Fever". Eurasian J Med. 43 (2): 79–82. doi:10.5152/eajm.2011.18. PMC 4261345. PMID 25610168.

[SoubrierDubost2009-21] Soubrier, Martin; Dubost, Jean Jacques; Thiéblot, Philippe; Ristori, Jean Michel (2009). "Oligo-arthritis and type IV hyperlipoproteinemia". Joint Bone Spine. 76 (1): 95–97. doi:10.1016/j.jbspin.2008.03.009. ISSN 1297-319X.

[GanemPrince2004-22] Ganem, Don; Prince, Alfred M. (2004). "Hepatitis B Virus Infection — Natural History and Clinical Consequences". New England Journal of Medicine. 350 (11): 1118–1129. doi:10.1056/NEJMra031087. ISSN 0028-4793.

[pmid849368-23] Spruance SL, Metcalf R, Smith CB, Griffiths MM, Ward JR (March 1977). "Chronic arthropathy associated with rubella vaccination". Arthritis Rheum. 20 (2): 741–7. PMID 849368.

[pmid10910181-24] Moore TL (July 2000). "Parvovirus-associated arthritis". Curr Opin Rheumatol. 12 (4): 289–94. PMID 10910181.

[pmid23213512-25] Bellato E, Marini E, Castoldi F, Barbasetti N, Mattei L, Bonasia DE; et al. (2012). "Fibromyalgia syndrome: etiology, pathogenesis, diagnosis, and treatment". Pain Res Treat. 2012: 426130. doi:10.1155/2012/426130. PMC 3503476. PMID 23213512.

[pmid7740308-26] McLean RM, Podell DN (February 1995). "Bone and joint manifestations of hypothyroidism". Semin. Arthritis Rheum. 24 (4): 282–90. PMID 7740308.

[pmid23592730-27] Magrinelli F, Zanette G, Tamburin S (October 2013). "Neuropathic pain: diagnosis and treatment". Pract Neurol. 13 (5): 292–307. doi:10.1136/practneurol-2013-000536. PMID 23592730.

[pmid17002489-28] Skowrońska-Jóźwiak E, Lorenc RS (2006). "Metabolic bone disease in children : etiology and treatment options". Treat Endocrinol. 5 (5): 297–318. PMID 17002489.

[pmid16001092-29] Trivedi MH (2004). "The link between depression and physical symptoms". Prim Care Companion J Clin Psychiatry. 6 (Suppl 1): 12–6. PMC 486942. PMID 16001092.

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@@ Line 5: / Line 5: @@
 == Differential Diagnosis of Diseases That Cause Polyarthritis ==
 ===Differentiating the diseases that can cause polyarthritis:===
+'''''To review the differential diagnosis of polyarthritis with joint swelling, [[Polyarthritis with joint swelling|click here]]'''.''
-{| align="center" style="border: 0px; font-size: 90%; margin: 3px;"
+'''''To review the differential diagnosis of polyarthritis with fever, [[Polyarthritis with fever|click here]]'''.''
+'''''To review the differential diagnosis of polyarthritis with weight loss, [[Polyarthritis with weight loss|click here]]'''.''
+'''''To review the differential diagnosis of polyarthritis with claudication, [[Polyarthritis with claudication|click here]]'''.''
+'''''To review the differential diagnosis of polyarthritis with morning stiffness, [[Polyarthritis with morning stiffness|click here]]'''.''
+'''''To review the differential diagnosis of polyarthritis with local erythema, [[Polyarthritis with local erythema|click here]]'''.''
+'''''To review the differential diagnosis of polyarthritis with joint swelling and fever, [[Polyarthritis with joint swelling and fever|click here]]'''.''
+'''''To review the differential diagnosis of polyarthritis with joint swelling, fever, and weight loss, [[Polyarthritis with joint swelling, fever, and weight loss|click here]]'''.''
+<small><small>
+{| class="wikitable" align="center" style="border: 0px; font-size: 90%; margin: 3px;"
 ! colspan="3" rowspan="4" align="center" style="background:#4479BA; color: #FFFFFF;" |Diseases
 | colspan="7" rowspan="1" align="center" style="background:#4479BA; color: #FFFFFF;" |'''Clinical manifestations'''
@@ Line 48: / Line 63: @@
 ! style="background: #F5F5F5; padding: 5px;" |-
 ! style="background: #F5F5F5; padding: 5px;" |Cell counts 500-98,000/µL
-! style="background: #F5F5F5; padding: 5px;" |[[Microscopic hematuria]], [[Proteinuria]], ↑[[ALT]] or [[AST]]
+! style="background: #F5F5F5; padding: 5px;" |[[Microscopic hematuria]], [[proteinuria]], ↑[[ALT]] or [[AST]]
-! style="background: #F5F5F5; padding: 5px;" |-
+! style="background: #F5F5F5; padding: 5px;" |[[Knee joint]] effusion, erosion and permanent damage, [[enthesopathy]]
 ! style="background: #F5F5F5; padding: 5px;" |-
 ! style="background: #F5F5F5; padding: 5px;" |-
 ! style="background: #F5F5F5; padding: 5px;" |[[Fibrosis]] of the deeper [[dermis]] and hyalinization of collagen bundles
 ! style="background: #F5F5F5; padding: 5px;" |[[Serological testing|Serologic '''tests''']]
-! style="background: #F5F5F5; padding: 5px;" |[[Erythema migrans]]
+! style="background: #F5F5F5; padding: 5px;" |[[Third degree heart block]]
 |-
 ! style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Bacterial endocarditis]]<ref name="pmid28630844">{{cite journal| author=Soor P, Sharma N, Rao C| title=Multifocal Septic Arthritis Secondary to Infective Endocarditis: A Rare Case Report. | journal=J Orthop Case Rep | year= 2017 | volume= 7 | issue= 1 | pages= 65-68 | pmid=28630844 | doi=10.13107/jocr.2250-0685.692 | pmc=5458702 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28630844  }}</ref>
@@ Line 75: / Line 90: @@
 ! style="background: #F5F5F5; padding: 5px;" |[[Vertebral osteomyelitis]]
 |-
-! rowspan="3" style="background: #DCDCDC; padding: 5px; text-align: center;" |'''[[Reactive arthritis|Postinfectious (reactive) arthritis]]'''
+! rowspan="3" style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Postinfectious arthritis'''
 ! style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Rheumatic fever]]<ref name="pmid23703332">{{cite journal| author=Kumar RK, Tandon R| title=Rheumatic fever & rheumatic heart disease: the last 50 years. | journal=Indian J Med Res | year= 2013 | volume= 137 | issue= 4 | pages= 643-58 | pmid=23703332 | doi= | pmc=3724245 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23703332  }}</ref>
 ! style="background: #F5F5F5; padding: 5px;" |+
@@ Line 86: / Line 101: @@
 ! style="background: #F5F5F5; padding: 5px;" |[[Leukocytosis]]
 ! style="background: #F5F5F5; padding: 5px;" |↑
-! style="background: #F5F5F5; padding: 5px;" |Sterile inflammatory reaction with cells<20,000/μL
+! style="background: #F5F5F5; padding: 5px;" |Sterile inflammatory reaction with cells < 20,000/μL
 ! style="background: #F5F5F5; padding: 5px;" |[[Anti-streptolysin O titer|Streptococcal antibody titer]]
 ! style="background: #F5F5F5; padding: 5px;" |[[Cardiomegaly]]
 ! style="background: #F5F5F5; padding: 5px;" |[[Valvular Diseases|Valvular]] or [[pericardial calcification]]
 ! style="background: #F5F5F5; padding: 5px;" |[[Echocardiography|Echocardiographic]] changes in heart valves
-! style="background: #F5F5F5; padding: 5px;" |[[Edema]], [[Fibrinoid necrosis]], [[Mononuclear cell|Mononuclear cell infiltrate]]
+! style="background: #F5F5F5; padding: 5px;" |[[Edema]], [[fibrinoid necrosis]], [[Mononuclear cell|mononuclear cell infiltrate]]
 ! style="background: #F5F5F5; padding: 5px;" |[[Echocardiography]]
-! style="background: #F5F5F5; padding: 5px;" |Chorea, Carditis
+! style="background: #F5F5F5; padding: 5px;" |[[Sydenham's chorea]], [[carditis]]
 |-
 ! style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Reactive arthritis]]<ref name="pmid15084505">{{cite journal| author=Colmegna I, Cuchacovich R, Espinoza LR| title=HLA-B27-associated reactive arthritis: pathogenetic and clinical considerations. | journal=Clin Microbiol Rev | year= 2004 | volume= 17 | issue= 2 | pages= 348-69 | pmid=15084505 | doi= | pmc=387405 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15084505  }}</ref>
@@ Line 110: / Line 125: @@
 ! style="background: #F5F5F5; padding: 5px;" |[[Sacroiliitis]]
 ! style="background: #F5F5F5; padding: 5px;" |[[Enthesitis]] in [[ultrasonography]]
-! style="background: #F5F5F5; padding: 5px;" |[[Keratoderma blennorrhagica|Keratoderma blennorrhagicum]],  [[Balanitis circinata]]
+! style="background: #F5F5F5; padding: 5px;" |[[Keratoderma blennorrhagica|Keratoderma blennorrhagicum]],  [[balanitis circinata]]
 ! style="background: #F5F5F5; padding: 5px;" | [[Spondyloarthritis]] and unequivocal demonstration of preceding infection
-! style="background: #F5F5F5; padding: 5px;" |[[Conjunctivitis]], [[Uveitis]]
+! style="background: #F5F5F5; padding: 5px;" |[[Conjunctivitis]], [[uveitis]]
 |-
 ! style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Enteric Bacilli|Enteric infection]]<ref name="Hill Gaston2003">{{cite journal|last1=Hill Gaston|first1=J|title=Arthritis associated with enteric infection|journal=Best Practice & Research Clinical Rheumatology|volume=17|issue=2|year=2003|pages=219–239|issn=15216942|doi=10.1016/S1521-6942(02)00104-3}}</ref>
@@ Line 121: / Line 136: @@
 ! style="background: #F5F5F5; padding: 5px;" |-
 ! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |[[Keratoderma]] and psoriaform lesions, [[Erythema nodosum]]
+! style="background: #F5F5F5; padding: 5px;" |[[Keratoderma]] and psoriaform lesions, [[erythema nodosum]]
 ! style="background: #F5F5F5; padding: 5px;" |[[Neutrophilia]]
 ! style="background: #F5F5F5; padding: 5px;" |↑
@@ Line 131: / Line 146: @@
 ! style="background: #F5F5F5; padding: 5px;" |[[Neutrophilic myelocyte|Neutrophilic]] infiltration in [[synovial]] tissues
 ! style="background: #F5F5F5; padding: 5px;" |[[PCR]] of causative [[organism]] in [[synovial fluid]]
-! style="background: #F5F5F5; padding: 5px;" |[[Diarrhea]], [[Enthesopathy]]
+! style="background: #F5F5F5; padding: 5px;" |[[Diarrhea]], [[enthesopathy]]
 |-
 ! rowspan="3" style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Other [[Seronegative spondyloarthritis|seronegative spondyloarthritides]]'''
@@ Line 151: / Line 166: @@
 ! style="background: #F5F5F5; padding: 5px;" |Chronic [[inflammation]] with [[CD4+|CD4<sup>+</sup>]] and [[CD8+ T cells|CD8<sup>+</sup> T lymphocytes]] and [[macrophages]]
 ! style="background: #F5F5F5; padding: 5px;" |[[X-rays|Plain x-rays]]
-! style="background: #F5F5F5; padding: 5px;" |Peripheral [[enthesitis]], [[Uveitis]]
+! style="background: #F5F5F5; padding: 5px;" |Peripheral [[enthesitis]], [[uveitis]]
 |-
 ! style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Psoriatic arthritis]]<ref name="pmid23493653">{{cite journal| author=Sankowski AJ, Lebkowska UM, Cwikła J, Walecka I, Walecki J| title=Psoriatic arthritis. | journal=Pol J Radiol | year= 2013 | volume= 78 | issue= 1 | pages= 7-17 | pmid=23493653 | doi=10.12659/PJR.883763 | pmc=3596149 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23493653  }}</ref>
@@ Line 162: / Line 177: @@
 ! style="background: #F5F5F5; padding: 5px;" |Scaly [[Erythematous rash|erythematous plaques]],
-[[Guttate psoriasis|Guttate lesions]], Lakes of [[pus]],
+[[Guttate psoriasis|guttate lesions]], lakes of [[pus]],
 [[Erythroderma]]
@@ Line 169: / Line 184: @@
 ! style="background: #F5F5F5; padding: 5px;" |High [[WBC]] count (5000-15,000/µL) with >50% of [[PMN|PMN leukocytes]]
 ! style="background: #F5F5F5; padding: 5px;" |↑[[RF]], [[ANA]], [[IgA]]
-! style="background: #F5F5F5; padding: 5px;" |[[Joint]]-space narrowing, [[Periostitis|Fluffy periostitis]]
+! style="background: #F5F5F5; padding: 5px;" |[[Joint]]-space narrowing, [[Periostitis|fluffy periostitis]]
-! style="background: #F5F5F5; padding: 5px;" |Pencil-in-cup deformity, Early signs of [[synovitis]]
+! style="background: #F5F5F5; padding: 5px;" |Pencil-in-cup deformity, early signs of [[synovitis]]
-! style="background: #F5F5F5; padding: 5px;" |[[Synovitis|Sacroiliitic synovitis]], [[Enthesitis]] in [[MRI]]
+! style="background: #F5F5F5; padding: 5px;" |[[Synovitis|Sacroiliitic synovitis]], [[enthesitis]] in [[MRI]]
-! style="background: #F5F5F5; padding: 5px;" |Lack of intrasynovial [[Immunoglobulin A|Ig]] and [[RF]], Greater propensity for [[Ankylosis|fibrous ankylosis]], [[Osseous|osseous resorption]], and [[Heterotopic ossification|heterotopic bone formation]]
+! style="background: #F5F5F5; padding: 5px;" |Lack of intrasynovial [[Immunoglobulin A|Ig]] and [[RF]], greater propensity for [[Ankylosis|fibrous ankylosis]], [[Osseous|osseous resorption]], and [[Heterotopic ossification|heterotopic bone formation]]
 ! style="background: #F5F5F5; padding: 5px;" |Clinical findings
-! style="background: #F5F5F5; padding: 5px;" |[[Onycholysis]], [[Splinter hemorrhage|Splinter hemorrhages]]
+! style="background: #F5F5F5; padding: 5px;" |[[Onycholysis]], [[splinter hemorrhages]]
 |-
 ! style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Inflammatory bowel disease]]<ref name="pmid22933865">{{cite journal| author=Orchard TR| title=Management of arthritis in patients with inflammatory bowel disease. | journal=Gastroenterol Hepatol (N Y) | year= 2012 | volume= 8 | issue= 5 | pages= 327-9 | pmid=22933865 | doi= | pmc=3424429 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22933865  }}</ref>
@@ Line 183: / Line 198: @@
 ! style="background: #F5F5F5; padding: 5px;" |+
 ! style="background: #F5F5F5; padding: 5px;" |+/-
-! style="background: #F5F5F5; padding: 5px;" |[[Pyoderma gangrenosum]] ([[ulcerative colitis]]),  [[Erythema nodosum]] ([[Crohn disease]])
+! style="background: #F5F5F5; padding: 5px;" |[[Pyoderma gangrenosum]] ([[ulcerative colitis]]),  [[erythema nodosum]] ([[Crohn disease]])
-! style="background: #F5F5F5; padding: 5px;" |[[Iron deficiency anemia]], [[Leukocytosis]], [[Thrombocytosis]]
+! style="background: #F5F5F5; padding: 5px;" |[[Iron deficiency anemia]], [[leukocytosis]], [[thrombocytosis]]
 ! style="background: #F5F5F5; padding: 5px;" |↑
 ! style="background: #F5F5F5; padding: 5px;" |Mild to moderate [[Inflammatory|inflammatory fluid]], [[PMN]] predominance
-! style="background: #F5F5F5; padding: 5px;" |↑[[RF]], [[Endomysium|Antiendomysial Ab]],  [[Anti-transglutaminase antibodies|Antitransglutaminase Ab]]
+! style="background: #F5F5F5; padding: 5px;" |↑[[RF]], anti-endomysial Ab,  [[Anti-transglutaminase antibodies|anti-transglutaminase Ab]]
-! style="background: #F5F5F5; padding: 5px;" |Bilateral [[sacroiliitis]], Syndesmophytes and apophyseal joint involvement in [[spine]]
+! style="background: #F5F5F5; padding: 5px;" |Bilateral [[sacroiliitis]], syndesmophytes and apophyseal joint involvement in [[spine]]
 ! style="background: #F5F5F5; padding: 5px;" |-
 ! style="background: #F5F5F5; padding: 5px;" |Early detection of [[Spinal stenosis|spinal]] and [[Sacroiliac joint|sacroiliac lesions]] in [[MRI]]
@@ Line 203: / Line 218: @@
 ! style="background: #F5F5F5; padding: 5px;" |-
 ! style="background: #F5F5F5; padding: 5px;" |[[Rheumatoid nodules]]
-! style="background: #F5F5F5; padding: 5px;" |[[Anemia]], [[Thrombocytosis]]
+! style="background: #F5F5F5; padding: 5px;" |[[Anemia]], [[thrombocytosis]]
 ! style="background: #F5F5F5; padding: 5px;" |↑
 ! style="background: #F5F5F5; padding: 5px;" |[[WBC]] count >2000/µL (generally 5000-50,000/µL), with [[neutrophil]] predominance (60-80%)
-! style="background: #F5F5F5; padding: 5px;" |[[Anti-citrullinated protein antibody|Anti-CCP Ab]], [[Hyperuricemia]]
+! style="background: #F5F5F5; padding: 5px;" |[[Anti-citrullinated protein antibody|Anti-CCP Ab]], [[hyperuricemia]]
 ! style="background: #F5F5F5; padding: 5px;" |[[Joint]]-space narrowing
 ! style="background: #F5F5F5; padding: 5px;" |[[Fractures|Microfractures]]
@@ Line 241: / Line 256: @@
 ! style="background: #F5F5F5; padding: 5px;" |-
 ! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |[[Malar rash]], [[Photosensitivity]], [[Discoid lupus]]
+! style="background: #F5F5F5; padding: 5px;" |[[Malar rash]], [[photosensitivity]], [[discoid lupus]]
-! style="background: #F5F5F5; padding: 5px;" |[[Leukopenia]], [[Lymphopenia]], [[Anemia]], [[Thrombocytopenia]]
+! style="background: #F5F5F5; padding: 5px;" |[[Leukopenia]], [[lymphopenia]], [[anemia]], [[thrombocytopenia]]
 ! style="background: #F5F5F5; padding: 5px;" |↑
 ! style="background: #F5F5F5; padding: 5px;" |Cell count from < 25% [[PMNs]] (non-[[inflammatory]] effusions) to > 50% [[PMNs]] ([[inflammatory]] effusions)
-! style="background: #F5F5F5; padding: 5px;" |[[Creatine kinase]], [[Liver function tests|LFT]], [[ANA]], [[Anti-dsDNA antibody|Anti-dsDNA]], [[Anti-SM antibody|Anti-Sm]], [[Lupus anticoagulant]]
+! style="background: #F5F5F5; padding: 5px;" |[[Creatine kinase]], [[Liver function tests|LFT]], [[ANA]], [[Anti-dsDNA antibody|anti-dsDNA Ab]], [[Anti-SM antibody|Anti-Smith Ab]], [[lupus anticoagulant]]
 ! style="background: #F5F5F5; padding: 5px;" |Periarticular [[osteopenia]] and [[Soft tissue injury|soft-tissue swelling]] without [[Erosion (dental)|erosions]]
-! style="background: #F5F5F5; padding: 5px;" |[[Interstitial lung disease]], [[Pneumonitis]], [[Pulmonary emboli]], [[Alveolar Cyst Disease|Alveolar hemorrhage]]
+! style="background: #F5F5F5; padding: 5px;" |[[Interstitial lung disease]], [[pneumonitis]], [[pulmonary emboli]], alveolar hemorrhage
-! style="background: #F5F5F5; padding: 5px;" |[[Pericardial effusion]], [[Pulmonary hypertension]], [[Libman-Sacks endocarditis|Verrucous Libman-Sacks endocarditis]] in [[echocardiography]]
+! style="background: #F5F5F5; padding: 5px;" |[[Pericardial effusion]], [[pulmonary hypertension]], [[Libman-Sacks endocarditis|verrucous Libman-Sacks endocarditis]] on [[echocardiography]]
 ! style="background: #F5F5F5; padding: 5px;" |[[Inflammatory]] infiltrates at the dermoepidermal junction and vacuolar change in the basal [[Columnar epithelium|columnar cells]]
-! style="background: #F5F5F5; padding: 5px;" |[[Anti-dsDNA antibody|Anti-dsDNA]]
+! style="background: #F5F5F5; padding: 5px;" |[[Anti-dsDNA antibody]]
-! style="background: #F5F5F5; padding: 5px;" |[[Rheumatoid arthritis]], [[Serositis]], [[Oral ulcers]]
+! style="background: #F5F5F5; padding: 5px;" |[[Rheumatoid arthritis]], [[serositis]], [[oral ulcers]]
 |-
 ! style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Systemic vasculitis]]<ref name="pmid27964796">{{cite journal |vauthors=Watts RA, Scott DG |title=Vasculitis and inflammatory arthritis |journal=Best Pract Res Clin Rheumatol |volume=30 |issue=5 |pages=916–931 |date=October 2016 |pmid=27964796 |doi=10.1016/j.berh.2016.10.008 |url=}}</ref>
@@ Line 260: / Line 275: @@
 ! style="background: #F5F5F5; padding: 5px;" |-
 ! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |[[Petechia]], [[Purpura]]
+! style="background: #F5F5F5; padding: 5px;" |[[Petechia]], [[purpura]]
-! style="background: #F5F5F5; padding: 5px;" |[[Anemia]], [[Thrombocytosis]]
+! style="background: #F5F5F5; padding: 5px;" |[[Anemia]], [[thrombocytosis]]
 ! style="background: #F5F5F5; padding: 5px;" |↑
 ! style="background: #F5F5F5; padding: 5px;" |-
@@ Line 267: / Line 282: @@
 ! style="background: #F5F5F5; padding: 5px;" |[[Soft tissue pathology|Soft tissue swelling]] with mild [[Erosion (dental)|erosions]]
 ! style="background: #F5F5F5; padding: 5px;" |Focal regions of [[infarction]] or [[hemorrhage]]
-! style="background: #F5F5F5; padding: 5px;" |Multiple [[Aneurysm|microaneurysms]],[[Hemorrhage]] due to focal [[rupture]], [[Occlusion]] in [[angiography]]
+! style="background: #F5F5F5; padding: 5px;" |Multiple [[Aneurysm|microaneurysms]],[[hemorrhage]] due to focal [[rupture]], [[occlusion]] in [[angiography]]
 ! style="background: #F5F5F5; padding: 5px;" |Acute destruction of the [[Tunica media|media]] by [[neutrophils]], with loss of [[elastic fibers]]
 ! style="background: #F5F5F5; padding: 5px;" |[[Angiography]]
-! style="background: #F5F5F5; padding: 5px;" |[[Peripheral neuropathy]], [[Livedo reticularis]]
+! style="background: #F5F5F5; padding: 5px;" |[[Peripheral neuropathy]], [[livedo reticularis]]
 |-
 ! style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Systemic sclerosis]]<ref name="AvouacClements2012">{{cite journal|last1=Avouac|first1=J.|last2=Clements|first2=P. J.|last3=Khanna|first3=D.|last4=Furst|first4=D. E.|last5=Allanore|first5=Y.|title=Articular involvement in systemic sclerosis|journal=Rheumatology|volume=51|issue=8|year=2012|pages=1347–1356|issn=1462-0324|doi=10.1093/rheumatology/kes041}}</ref>
@@ Line 279: / Line 294: @@
 ! style="background: #F5F5F5; padding: 5px;" |-
 ! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |3 phases of (1) [[Edema|Edematous]], (2) [[Induration|Indurative]], and (3) [[Atrophic]]
+! style="background: #F5F5F5; padding: 5px;" |3 phases of skin manifestation: Edematous,  [[Induration|indurative]], and  [[atrophic]]
 ! style="background: #F5F5F5; padding: 5px;" |[[Thrombocytopenia]]
 ! style="background: #F5F5F5; padding: 5px;" |↑
@@ Line 286: / Line 301: @@
 [[Creatine phosphokinase]]
-! style="background: #F5F5F5; padding: 5px;" |Juxta-[[articular]] [[osteoporosis]], Joint space narrowing, Frank [[Erosion (dental)|erosions]]
+! style="background: #F5F5F5; padding: 5px;" |Juxta-[[articular]] [[osteoporosis]], joint space narrowing, frank [[Erosion (dental)|erosions]]
 ! style="background: #F5F5F5; padding: 5px;" |[[Synovial inflammation]]
 ! style="background: #F5F5F5; padding: 5px;" |[[Synovial]] [[vascularity]] in [[doppler ultrasonography]]
-! style="background: #F5F5F5; padding: 5px;" |[[Epidermal]] [[skin appendages]] [[atrophy]], Broad and hyalinized [[collagen]] fibers in the [[reticular dermis]]
+! style="background: #F5F5F5; padding: 5px;" |[[Epidermal]] [[skin appendages]] [[atrophy]], broad and hyalinized [[collagen]] fibers in the [[reticular dermis]]
 ! style="background: #F5F5F5; padding: 5px;" |[[Histopathology]]
 ! style="background: #F5F5F5; padding: 5px;" |[[Raynaud phenomenon]], [[Tendon]] [[Friction rub|friction rubs]]
@@ Line 300: / Line 315: @@
 ! style="background: #F5F5F5; padding: 5px;" |-
 ! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |[[Heliotropism|Heliotrope rash]], [[Dermatomyositis|Gottron papules]], [[Poikiloderma of civatte|Poikiloderma]]
+! style="background: #F5F5F5; padding: 5px;" |[[Heliotropism|Heliotrope rash]], [[Polymyositis and dermatomyositis#physical examination|Gottron papules]], [[Poikiloderma of civatte|poikiloderma]]
 ! style="background: #F5F5F5; padding: 5px;" |[[Normocytic normochromic anemia]]
 ! style="background: #F5F5F5; padding: 5px;" |↑
 ! style="background: #F5F5F5; padding: 5px;" |Predominantly [[mononuclear cells]] and large macrophage-like cells
-! style="background: #F5F5F5; padding: 5px;" |Anti–Mi-2 antibodies, Anti–Jo-1 antibodies, [[Creatine kinase]], [[ANA]]
+! style="background: #F5F5F5; padding: 5px;" |Anti–Mi-2 antibodies, anti–Jo-1 antibodies, [[creatine kinase]], [[ANA]]
 ! style="background: #F5F5F5; padding: 5px;" |Marginal [[Erosion (dental)|erosions]] and periarticular [[calcification]]
 ! style="background: #F5F5F5; padding: 5px;" |-
@@ Line 320: / Line 335: @@
 ! style="background: #F5F5F5; padding: 5px;" |+
 ! style="background: #F5F5F5; padding: 5px;" |Mild [[papules]] and [[nodules]]
-! style="background: #F5F5F5; padding: 5px;" |[[Anemia]], [[Thrombocytosis]]
+! style="background: #F5F5F5; padding: 5px;" |[[Anemia]], [[thrombocytosis]]
 ! style="background: #F5F5F5; padding: 5px;" |↑
 ! style="background: #F5F5F5; padding: 5px;" |High [[WBC]] count (5000-15,000/µL) with >50% of [[PMN|PMN leukocytes]]
@@ Line 326: / Line 341: @@
 ! style="background: #F5F5F5; padding: 5px;" |Soft tissue swelling,
-[[Osteopenia]],
+[[osteopenia]],
-Joint-space narrowing
+joint-space narrowing
 ! style="background: #F5F5F5; padding: 5px;" |[[Synovial inflammation]]
 ! style="background: #F5F5F5; padding: 5px;" |Inflamed [[synovium]] in [[ultrasonography]]
@@ Line 346: / Line 361: @@
 ! style="background: #F5F5F5; padding: 5px;" |↑
 ! style="background: #F5F5F5; padding: 5px;" |Cell count < 25% [[PMNs]] (non-[[inflammatory]])
-! style="background: #F5F5F5; padding: 5px;" |Serum [[complement]] levels, [[Human leukocyte antigen]] (HLA)-B51
+! style="background: #F5F5F5; padding: 5px;" |Serum [[complement]] levels, [[human leukocyte antigen]] (HLA)-B51
 ! style="background: #F5F5F5; padding: 5px;" |Soft tissue swelling
 ! style="background: #F5F5F5; padding: 5px;" |Non-erosive [[synovitis]]
 ! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |Dermal vessels infiltration with lymphocytes and plasma cells, [[Immune]] deposits of [[Immunoglobulin M|immunoglobulin M (IgM)]] and [[C3]]
+! style="background: #F5F5F5; padding: 5px;" |Dermal vessels infiltration with lymphocytes and plasma cells, [[immune]] deposits of [[Immunoglobulin M|immunoglobulin M (IgM)]] and [[C3]]
 ! style="background: #F5F5F5; padding: 5px;" |Clinical findings
-! style="background: #F5F5F5; padding: 5px;" |[[Oral ulcer]], [[Mucosal]] erosion
+! style="background: #F5F5F5; padding: 5px;" |[[Oral ulcer]], [[mucosal]] erosion
 |-
 ! style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Relapsing polychondritis]]<ref name="pmid27708954">{{cite journal| author=Emmungil H, Aydın SZ| title=Relapsing polychondritis. | journal=Eur J Rheumatol | year= 2015 | volume= 2 | issue= 4 | pages= 155-159 | pmid=27708954 | doi=10.5152/eurjrheum.2015.0036 | pmc=5047229 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27708954  }}</ref>
@@ Line 362: / Line 377: @@
 ! style="background: #F5F5F5; padding: 5px;" |-
 ! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |[[Leukocytosis]], [[Anemia]]
+! style="background: #F5F5F5; padding: 5px;" |[[Leukocytosis]], [[anemia]]
 ! style="background: #F5F5F5; padding: 5px;" |-
 ! style="background: #F5F5F5; padding: 5px;" |Cell count < 25% [[PMNs]] (non-[[inflammatory]])
@@ Line 369: / Line 384: @@
 ! style="background: #F5F5F5; padding: 5px;" |[[Calcification]] of [[Cartilaginous|cartilaginous structures]]
 ! style="background: #F5F5F5; padding: 5px;" |[[Aortic root|Aortic root dilatation]] and degree of [[aortic regurgitation]] in [[echocardiography]]
-! style="background: #F5F5F5; padding: 5px;" |Chondrolysis, [[Chondritis]], Perichondritis
+! style="background: #F5F5F5; padding: 5px;" |Chondrolysis, [[chondritis]], Perichondritis
 ! style="background: #F5F5F5; padding: 5px;" |Clinical findings coupled with imaging
-! style="background: #F5F5F5; padding: 5px;" |[[Ear pain]] and redness, [[Polyarthritis]]
+! style="background: #F5F5F5; padding: 5px;" |[[Ear pain]] and redness
 |-
 ! rowspan="4" style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Other systemic illnesses'''
@@ Line 385: / Line 400: @@
 ! style="background: #F5F5F5; padding: 5px;" |↑
 ! style="background: #F5F5F5; padding: 5px;" |Cell count < 25% [[PMNs]] (non-[[inflammatory]])
-! style="background: #F5F5F5; padding: 5px;" | [[IL-2]] and [[Interferon gamma|IFN-γ]], ↑[[Angiotensin-converting enzyme|ACE]], ↑[[Vitamin D|1, 25-dihydroxyvitamin D]]
+! style="background: #F5F5F5; padding: 5px;" | [[IL-2]] and [[Interferon gamma|IFN-γ]], ↑ [[Angiotensin-converting enzyme|ACE]], ↑ [[Vitamin D|1, 25-dihydroxyvitamin D]]
 ! style="background: #F5F5F5; padding: 5px;" |Bilateral [[Adenopathy|hilar adenopathy]]
 ! style="background: #F5F5F5; padding: 5px;" |Active [[alveolitis]] or [[fibrosis]]
@@ Line 391: / Line 406: @@
 ! style="background: #F5F5F5; padding: 5px;" |[[Granuloma|Noncaseating granulomas (NCGs)]]
 ! style="background: #F5F5F5; padding: 5px;" |[[Histopathology|Histological confirmation]]
-! style="background: #F5F5F5; padding: 5px;" |[[Heart block]], [[Ocular disease|Ocular lesion]]
+! style="background: #F5F5F5; padding: 5px;" |[[Heart block]], [[Ocular|ocular lesion]]
 |-
 ! style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Palindromic rheumatism]]<ref name="pmid21206416">{{cite journal |vauthors=Iyer VR, Cohen GL |title=Palindromic rheumatism |journal=South. Med. J. |volume=104 |issue=2 |pages=147–9 |date=February 2011 |pmid=21206416 |doi=10.1097/SMJ.0b013e318200c4cc |url=}}</ref>
@@ Line 406: / Line 421: @@
 ! style="background: #F5F5F5; padding: 5px;" |[[RF]], [[Anti-citrullinated protein antibody|Anti-CCP antibody]], ↑[[Creatinine|Cr]] or [[Blood urea nitrogen|BUN]],
-↑[[ALT]] or [[AST]], [[ANA]]
+↑[[ALT]] and/or [[AST]], [[ANA]]
 ! style="background: #F5F5F5; padding: 5px;" |[[Joint (anatomy)|Effusions in joints]]
 ! style="background: #F5F5F5; padding: 5px;" |[[Fractures|Microfractures]]
@@ Line 425: / Line 440: @@
 ! style="background: #F5F5F5; padding: 5px;" |↑
 ! style="background: #F5F5F5; padding: 5px;" |Cell counts as high as 100,000/µL
-! style="background: #F5F5F5; padding: 5px;" |[[CRP]], [[Amyloid bodies|Amyloid A protein]], [[Fibrinogen]]
+! style="background: #F5F5F5; padding: 5px;" |[[CRP]], [[Amyloidosis|amyloid A protein]], [[fibrinogen]]
 ! style="background: #F5F5F5; padding: 5px;" |[[Synovial inflammation|Synovial effusions]]
 ! style="background: #F5F5F5; padding: 5px;" |[[Pleural effusions]]
@@ Line 431: / Line 446: @@
 ! style="background: #F5F5F5; padding: 5px;" |Massive [[amyloid]] infiltration of the [[blood vessels]] and [[endothelial]] side of the [[glomerular basement membrane]]
 ! style="background: #F5F5F5; padding: 5px;" |Clinical findings
-! style="background: #F5F5F5; padding: 5px;" |[[Abdominal pain]], [[Myalgia|Severe myalgia]], [[Scrotal swelling|Scrotal attacks]]
+! style="background: #F5F5F5; padding: 5px;" |[[Abdominal pain]], [[Myalgia|Severe myalgia]], [[Scrotal swelling|scrotal attacks]]
 |-
 ! style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Hyperlipoproteinemia|Hyperlipoproteinemias]]<ref name="SoubrierDubost2009">{{cite journal|last1=Soubrier|first1=Martin|last2=Dubost|first2=Jean Jacques|last3=Thiéblot|first3=Philippe|last4=Ristori|first4=Jean Michel|title=Oligo-arthritis and type IV hyperlipoproteinemia|journal=Joint Bone Spine|volume=76|issue=1|year=2009|pages=95–97|issn=1297319X|doi=10.1016/j.jbspin.2008.03.009}}</ref>
@@ Line 469: / Line 484: @@
 ! style="background: #F5F5F5; padding: 5px;" |-
 ! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |Deposition of [[immune complexes]], [[Cryoprecipitate|Cryoprecipitates]] containing [[HBsAg]] and [[Complement|complements]]
+! style="background: #F5F5F5; padding: 5px;" |Deposition of [[immune complexes]], [[cryoprecipitates]] containing [[HBsAg]] and [[Complement|complements]]
 ! style="background: #F5F5F5; padding: 5px;" |[[HBsAg]]
-! style="background: #F5F5F5; padding: 5px;" |[[Liver failure]], [[Jaundice|Icterus]]
+! style="background: #F5F5F5; padding: 5px;" |[[Liver failure]], [[icterus]]
 |-
 | style="background: #DCDCDC; padding: 5px; text-align: center;" |'''[[Rubella]]'''<ref name="pmid849368">{{cite journal |vauthors=Spruance SL, Metcalf R, Smith CB, Griffiths MM, Ward JR |title=Chronic arthropathy associated with rubella vaccination |journal=Arthritis Rheum. |volume=20 |issue=2 |pages=741–7 |date=March 1977 |pmid=849368 |doi= |url=}}</ref>
@@ Line 488: / Line 503: @@
 ! style="background: #F5F5F5; padding: 5px;" |-
 ! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |proliferation of the [[Synovial membrane|synovial lining cells]], without [[Inflammatory cells|inflammatory]]
+! style="background: #F5F5F5; padding: 5px;" |Proliferation of the [[Synovial membrane|synovial lining cells]], without [[Inflammatory cells|inflammatory]]
 [[Inflammatory cells|cells]]
 ! style="background: #F5F5F5; padding: 5px;" |[[Serological testing|Serological evidence]]
-! style="background: #F5F5F5; padding: 5px;" |[[Headache]], [[Malaise]]
+! style="background: #F5F5F5; padding: 5px;" |[[Headache]], [[malaise]], mimics [[Caplans syndrome|rheumatoid arthritis]]
 |-
 | style="background: #DCDCDC; padding: 5px; text-align: center;" |'''[[Parvovirus]]'''<ref name="pmid10910181">{{cite journal |vauthors=Moore TL |title=Parvovirus-associated arthritis |journal=Curr Opin Rheumatol |volume=12 |issue=4 |pages=289–94 |date=July 2000 |pmid=10910181 |doi= |url=}}</ref>
@@ Line 501: / Line 516: @@
 ! style="background: #F5F5F5; padding: 5px;" |-
 ! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |[[Fifth disease]]/ [[Erythema infectiosum]]
+! style="background: #F5F5F5; padding: 5px;" |[[Fifth disease]]/ [[erythema infectiosum]]
 ! style="background: #F5F5F5; padding: 5px;" |[[Aplastic crisis]]
 ! style="background: #F5F5F5; padding: 5px;" |↑
@@ Line 511: / Line 526: @@
 ! style="background: #F5F5F5; padding: 5px;" |[[Immune complex|Immune complex deposition]]
 ! style="background: #F5F5F5; padding: 5px;" |[[Parvovirus|Parvovirus IgM antibody]]
-! style="background: #F5F5F5; padding: 5px;" |Transient [[aplastic crisis]], [[Fetal]] [[infection]]
+! style="background: #F5F5F5; padding: 5px;" |Transient [[aplastic crisis]], fetal infection
 |-
 ! colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Fibromyalgia]]<ref name="pmid23213512">{{cite journal| author=Bellato E, Marini E, Castoldi F, Barbasetti N, Mattei L, Bonasia DE et al.| title=Fibromyalgia syndrome: etiology, pathogenesis, diagnosis, and treatment. | journal=Pain Res Treat | year= 2012 | volume= 2012 | issue=  | pages= 426130 | pmid=23213512 | doi=10.1155/2012/426130 | pmc=3503476 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23213512  }}</ref>
@@ Line 549: / Line 564: @@
 ! style="background: #F5F5F5; padding: 5px;" |Mild [[inflammation]]
 ! style="background: #F5F5F5; padding: 5px;" |Clinical findings
-! style="background: #F5F5F5; padding: 5px;" |[[Mucositis]], [[Enthesitis]]
+! style="background: #F5F5F5; padding: 5px;" |[[Mucositis]], [[enthesitis]]
 |-
 ! colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Hypothyroidism]]<ref name="pmid7740308">{{cite journal |vauthors=McLean RM, Podell DN |title=Bone and joint manifestations of hypothyroidism |journal=Semin. Arthritis Rheum. |volume=24 |issue=4 |pages=282–90 |date=February 1995 |pmid=7740308 |doi= |url=}}</ref>
@@ Line 568: / Line 583: @@
 ! style="background: #F5F5F5; padding: 5px;" |[[Growth plate|Physeal growth plate]] with little evidence of [[cartilage]] cellular proliferation
 ! style="background: #F5F5F5; padding: 5px;" |[[TSH]], [[T4]], [[T3]]
-! style="background: #F5F5F5; padding: 5px;" |Decreased [[Deep tendon reflex|DTR]], [[Fatigue]]
+! style="background: #F5F5F5; padding: 5px;" |Decreased [[Deep tendon reflex|DTR]], [[fatigue]]
 |-
 ! colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Neuropathic pain]]<ref name="pmid23592730">{{cite journal |vauthors=Magrinelli F, Zanette G, Tamburin S |title=Neuropathic pain: diagnosis and treatment |journal=Pract Neurol |volume=13 |issue=5 |pages=292–307 |date=October 2013 |pmid=23592730 |doi=10.1136/practneurol-2013-000536 |url=}}</ref>
@@ Line 581: / Line 596: @@
 ! style="background: #F5F5F5; padding: 5px;" |-
 ! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |[[Hyperglycemia]], [[Hypokalemia]], [[Hypocalcemia]]
+! style="background: #F5F5F5; padding: 5px;" |[[Hyperglycemia]], [[hypokalemia]], [[hypocalcemia]]
 ! style="background: #F5F5F5; padding: 5px;" |-
 ! style="background: #F5F5F5; padding: 5px;" |-
@@ Line 587: / Line 602: @@
 ! style="background: #F5F5F5; padding: 5px;" |-
 ! style="background: #F5F5F5; padding: 5px;" |[[Neurologic]] examination
-! style="background: #F5F5F5; padding: 5px;" |[[Paresthesia]], [[Dysesthesia]]
+! style="background: #F5F5F5; padding: 5px;" |[[Paresthesia]], [[dysesthesia]]
 |-
 ! colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |Metabolic bone disease<ref name="pmid17002489">{{cite journal |vauthors=Skowrońska-Jóźwiak E, Lorenc RS |title=Metabolic bone disease in children : etiology and treatment options |journal=Treat Endocrinol |volume=5 |issue=5 |pages=297–318 |date=2006 |pmid=17002489 |doi= |url=}}</ref>
@@ Line 606: / Line 621: @@
 ! style="background: #F5F5F5; padding: 5px;" |Decrease [[mineralization]] of [[bone matrix]]
 ! style="background: #F5F5F5; padding: 5px;" |Laboratory findings
-! style="background: #F5F5F5; padding: 5px;" |[[Bone pain]], [[Constipation]]
+! style="background: #F5F5F5; padding: 5px;" |[[Bone pain]], [[constipation]]
 |-
 ! colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Depression]]<ref name="pmid16001092">{{cite journal| author=Trivedi MH| title=The link between depression and physical symptoms. | journal=Prim Care Companion J Clin Psychiatry | year= 2004 | volume= 6 | issue= Suppl 1 | pages= 12-6 | pmid=16001092 | doi= | pmc=486942 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16001092  }}</ref>
@@ Line 625: / Line 640: @@
 ! style="background: #F5F5F5; padding: 5px;" |-
 ! style="background: #F5F5F5; padding: 5px;" |[[Psychological analysis|Psychological interview]]
-! style="background: #F5F5F5; padding: 5px;" |[[Psychomotor retardation|Slow psychomotor]], [[Muscle pain]]
+! style="background: #F5F5F5; padding: 5px;" |[[Psychomotor retardation|Slow psychomotor]], [[muscle pain]]
 |-
 |}
+</small></small>
 ==References==
 {{reflist|2}}

Polyarthritis: Difference between revisions

Latest revision as of 14:53, 30 May 2018

Differential Diagnosis of Diseases That Cause Polyarthritis

Differentiating the diseases that can cause polyarthritis:

References

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