Monoarthritis with joint swelling, fever, and weight loss

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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
Monoarthritis Neoplasms[1] + +/- + +/- - - Rash Normocytic normochromic anemia ↑  High WBC count (10,000-40,000/µL) Hypercalcemia, Hyperphosphatemia Peri-articular osteoblastic or osteoclastic lesion Elevation of the periosteum Intense radionuclide uptake in bone scan Spindle-shaped and atypical stromal cells, with irregular nuclei Clinical findings and imaging Nocturnal pain, Pathologic fractures
Infection Lyme disease[2] + + +/- +/- - - Erythema migrans Leukopenia, Thrombocytopenia - Cell counts 500-98,000/µL Microscopic hematuria, Proteinuria, ↑ALT or AST Knee joint effusion. Intra-articular edema  - Unspecific effusion, Synovial thickening or enhancement in MRI Fibrosis of the deeper dermis and hyalinization of collagen bundles Serologic tests Erythema migrans
Systemic disorders Myelodysplastic and leukemic disorders[3] + + + +/- - - Petechia and purpura Anemia,

Leukocytosis,

Thrombocytopenia

↑ WBC count >2000/µL (inflammatory), with neutrophilpredominance LDH, Uric acid Articular surface erosion, Synovial effusion Thickened synovium Synovitis in MRI Inflammatory cells infiltration in synovial tissue Bone marrow biopsy Fatigue, Nausea, Recurrent infections

References

  1. ↑ Askling J (October 2007). "Malignancy and rheumatoid arthritis". Curr Rheumatol Rep. 9 (5): 421–6. PMID 17915099.
  2. ↑ Arvikar SL, Steere AC (2015). "Diagnosis and treatment of Lyme arthritis". Infect Dis Clin North Am. 29 (2): 269–80. doi:10.1016/j.idc.2015.02.004. PMC 4443866. PMID 25999223.
  3. ↑ Mekinian A, Braun T, Decaux O, Falgarone G, Toussirot E, Raffray L; et al. (2014). "Inflammatory arthritis in patients with myelodysplastic syndromes: a multicenter retrospective study and literature review of 68 cases". Medicine (Baltimore). 93 (1): 1–10. doi:10.1097/MD.0000000000000011. PMC 4616329. PMID 24378738.
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