Polyarthritis with claudication

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

Diseases Clinical manifestations Para-clinical findings Gold standard Additional findings
Symptoms Physical examination
Lab Findings Imaging Histopathology
Joint Swelling Fever Weight loss Claudication Morning stiffness Local erythema Skin manifestation CBC ESR Synovial fluid Other X-ray CT scan Other
Polyarthritis Infectious arthritis Lyme disease[1] + + +/- +/- - - Erythema migrans Leukopenia, Thrombocytopenia - Cell counts 500-98,000/µL Microscopic hematuria, Proteinuria, ↑ALT or AST - - - Fibrosis of the deeper dermis and hyalinization of collagen bundles Serologic tests Erythema migrans
Other seronegative spondyloarthritides Ankylosing spondylitis[2] + - +/- +/- + - 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 
Rheumatoid arthritis[3] + - + + + - 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
Systemic rheumatic illnesses Systemic vasculitis[4] - - +/- + - - 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
Other systemic illnesses Palindromic rheumatism[5] + - - +/- + - Rheumatoid nodules Anemia ↑ High WBC count (5000-15,000/µL) with >50% of PMN leukocytes RF, Anti-CCP antibody, ↑Cr or BUN,

↑ALT 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
Polyarticular pain Fibromyalgia[6] - - - +/- +/- - Maculopapular rash Normal - Normal - - - - Mild inflammation Clinical findings Muscle pain

References

  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.
  2. ↑ 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.
  3. ↑ Heidari B (2011). "Rheumatoid Arthritis: Early diagnosis and treatment outcomes". Caspian J Intern Med. 2 (1): 161–70. PMC 3766928. PMID 24024009.
  4. ↑ 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.
  5. ↑ Iyer VR, Cohen GL (February 2011). "Palindromic rheumatism". South. Med. J. 104 (2): 147–9. doi:10.1097/SMJ.0b013e318200c4cc. PMID 21206416.
  6. ↑ 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.
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