Reactive Polyarticular Arthritis

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Overview

  • Monoarticular versus polyarticular
  • Inflammatory versus noninflammatory

Inflammatory:

  • History includes
  • prolonged and severe morning stiffness
  • fever
  • weight loss
  • spontaneous joint swelling
  • Physical reveals
  • local warmth
  • synovial thickening
  • frank effusions
  • Laboratory examination includes
  • anemia
  • elevated sedimentation rate or C-reactive protein level
  • thrombocytosis
References

Epidemiology and Demographics

References

Risk Factors

References

Screening

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Pathophysiology & Etiology

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Molecular Biology

  • Noninflammatory up to 3000 WBC and 25% PMNs
  • Inflammatory greater than 3000 WBC and 70% PMNs
  • Purulent greater than 50000 WBC and 90% PMNs


References

Genetics

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Natural History

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Diagnosis

Differential Diagnosis

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History and Symptoms

References

Physical Examination

Appearance of the Patient

Eyes

Ear Nose and Throat

Heart

Lungs

Abdomen

  • Spinal Exam
  • Range of motion
  • Chest expansion
  • Tenderness of spinous processes and sacroiliac joints
  • Abnormal curves
  • Muscle spasm

Extremities

  • Peripheral pulses
  • Neurological exam
  • Joints
  • Warmth
  • Synovial thickening
  • Effusions
  • Crepitation
  • Deformity
  • Tenderness
  • Active and passive range of motion

Neurologic

Other

  • Psoriasis
  • Psoriatic nails
  • Oral and genital ulcers
  • Funduscopic changes
  • Rubs
  • Bruits
References

Laboratory Findings

Electrolyte and Biomarker Studies

References

Electrocardiogram

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Chest X Ray

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MRI and CT

  • Looking for
  • cartilage loss
  • erosions
  • periarticular osteoporosis
  • osteophytes
  • periostitis
  • soft tissue changes.
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Echocardiography or Ultrasound

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Other Imaging Findings

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Other Diagnostic Studies

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Risk Stratification and Prognosis

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Treatment

Pharmacotherapy

Acute Pharmacotherapies

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Chronic Pharmacotherapies

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Surgery and Device Based Therapy

Indications for Surgery

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Pre-Operative Assessment

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Post-Operative Management

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Transplantation

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Primary Prevention

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Secondary Prevention

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Cost-Effectiveness of Therapy

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Future or Investigational Therapies

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Suggested Revisions to the Current Guidelines

References

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Acknowledgements

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List of contributors:


Suggested Reading and Key General References

Suggested Links and Web Resources

For Patients


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