View source for Monoarthritis with joint swelling

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{{CMG}}; {{AE}}{{EG}}
<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'''
! colspan="8" rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" |Para-clinical findings
| colspan="1" rowspan="4" align="center" style="background:#4479BA; color: #FFFFFF;" |'''Gold standard'''
! rowspan="4" align="center" style="background:#4479BA; color: #FFFFFF;" |Additional findings
|-
| colspan="4" rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" |'''Symptoms'''
! colspan="3" rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" |Physical examination
|-
! colspan="4" align="center" style="background:#4479BA; color: #FFFFFF;" |Lab Findings
! colspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" |Imaging
! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" |Histopathology
|-
! align="center" style="background:#4479BA; color: #FFFFFF;" |Joint Swelling
! colspan="1" rowspan="1" align="center" style="background:#4479BA; color: #FFFFFF;" |Fever
! align="center" style="background:#4479BA; color: #FFFFFF;" |Weight loss
! align="center" style="background:#4479BA; color: #FFFFFF;" |Claudication
! align="center" style="background:#4479BA; color: #FFFFFF;" |Morning stiffness
! align="center" style="background:#4479BA; color: #FFFFFF;" |Local erythema
! align="center" style="background:#4479BA; color: #FFFFFF;" |Skin manifestation
! align="center" style="background:#4479BA; color: #FFFFFF;" |CBC
! align="center" style="background:#4479BA; color: #FFFFFF;" |ESR
! align="center" style="background:#4479BA; color: #FFFFFF;" |Synovial fluid
! align="center" style="background:#4479BA; color: #FFFFFF;" |Other
! align="center" style="background:#4479BA; color: #FFFFFF;" |X-ray
! align="center" style="background:#4479BA; color: #FFFFFF;" |CT scan
! align="center" style="background:#4479BA; color: #FFFFFF;" |Other
|-
! rowspan="14" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Monoarthritis
! colspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Osteoarthritis]]<ref name="pmid28149655">{{cite journal| author=Chen D, Shen J, Zhao W, Wang T, Han L, Hamilton JL et al.| title=Osteoarthritis: toward a comprehensive understanding of pathological mechanism. | journal=Bone Res | year= 2017 | volume= 5 | issue=  | pages= 16044 | pmid=28149655 | doi=10.1038/boneres.2016.44 | pmc=5240031 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28149655  }}</ref>
!+
!-
!-
!-
!-
!-
![[Heberden's node|Heberden nodes]]
![[Anemia]]
!-
!Noninflammatory joint fluid
!Urinary [[pyridinium]] cross-links
!Joint-space loss, Subchondral bony [[sclerosis]], Cyst formation
!Malalignment of the patellofemoral [[joint]]
!Early diagnosis of [[osteoarthritis]] of the hand with [[bone scan]]
!-
!Clinical findings
!Microfracture, [[Bone pain]]
|-
! colspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Trauma]]<ref name="pmid27651925">{{cite journal| author=Punzi L, Galozzi P, Luisetto R, Favero M, Ramonda R, Oliviero F et al.| title=Post-traumatic arthritis: overview on pathogenic mechanisms and role of inflammation. | journal=RMD Open | year= 2016 | volume= 2 | issue= 2 | pages= e000279 | pmid=27651925 | doi=10.1136/rmdopen-2016-000279 | pmc=5013366 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27651925  }}</ref>
!+
!-
!-
!-
!-
!+
![[Wound]] or [[laceration]]
!-
!-
![[Hemarthrosis]]
!-
!Severe joint effusion, [[Bone fracture|Fracture]]
!Fracture, Synovial tear
!-
!-
![[X-ray]]
![[Deformity]], Severe [[pain]]
|-
! colspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Neoplasms]]<ref name="pmid17915099">{{cite journal |vauthors=Askling J |title=Malignancy and rheumatoid arthritis |journal=Curr Rheumatol Rep |volume=9 |issue=5 |pages=421–6 |date=October 2007 |pmid=17915099 |doi= |url=}}</ref>
!+
!-
!+
!+/-
!-
!-
![[Rash]]
![[Normocytic normochromic anemia]]
!↑
! High [[WBC]] count (10,000-40,000/µL)
![[Hypercalcemia]], [[Hyperphosphatemia]]
!Peri-[[articular]] [[Osteoblastic sarcoma|osteoblastic]] or [[Osteoclast|osteoclastic]] lesion
!Elevation of the [[periosteum]]
!Intense [[radionuclide]] uptake in [[bone scan]]
!Spindle-shaped and atypical [[Stromal cell|stromal cells]], with irregular [[nuclei]]
!Clinical findings and imaging
![[Pain|Nocturnal pain]], [[Pathological|Pathologic fractures]]
|-
! rowspan="3" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Infection]]
! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Gonococcal infection]]<ref name="pmid12787521">{{cite journal |vauthors=Bardin T |title=Gonococcal arthritis |journal=Best Pract Res Clin Rheumatol |volume=17 |issue=2 |pages=201–8 |date=April 2003 |pmid=12787521 |doi= |url=}}</ref>
!+
!+
!-
!-
!-
!+
![[Maculopapular]], [[Pustular rash|Pustular]], [[Vesicular]] lesions on an [[Erythematous|erythematous base]]
![[Leukocytosis]]
!↑
!Purulent with cell count > 50,000 [[WBC]]/µL (with PMNs > 90%)
![[Blood culture|Blood]] and [[Synovial fluid|synovial fluid culture]]
!Minor [[articular]] damage
!-
!-
!Dermal [[vasculitis]] with perivascular [[neutrophils]]
![[Nucleic acid amplification technique|Nucleic acid amplification tests (NAATs)]]
![[Dermatitis]], [[Tenosynovitis]]
|-
! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Nongonococcal urethritis|Nongonococcal bacterial infections]]<ref name="pmid194809972">{{cite journal |vauthors=García-De La Torre I, Nava-Zavala A |title=Gonococcal and nongonococcal arthritis |journal=Rheum. Dis. Clin. North Am. |volume=35 |issue=1 |pages=63–73 |date=February 2009 |pmid=19480997 |doi=10.1016/j.rdc.2009.03.001 |url=}}</ref>
!+
!+
!-
!-
!-
!+
!Local [[erythema]]
![[Leukocytosis]]
!↑
!Purulent with cell count > 50,000 [[WBC]]/µL (with PMNs > 90%)
![[Blood culture|Blood]] and [[Synovial fluid|synovial fluid culture]]
![[Joint]] effusion, [[Cartilage injuries|Cartilage destruction]], Joint space narrowing
![[Sternoclavicular joint|Sternoclavicular]] or [[sacroiliac joint]] infections
!Periarticular [[osteomyelitis]] in [[MRI]]
!-
![[Synovial fluid]] culture
![[Limp|Limping]], [[Malaise]]
|-
! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Lyme disease]]<ref name="pmid25999223">{{cite journal| author=Arvikar SL, Steere AC| title=Diagnosis and treatment of Lyme arthritis. | journal=Infect Dis Clin North Am | year= 2015 | volume= 29 | issue= 2 | pages= 269-80 | pmid=25999223 | doi=10.1016/j.idc.2015.02.004 | pmc=4443866 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25999223  }}</ref>
!+
!+
!+/-
!+/-
!-
!-
![[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
![[Serological testing|Serologic '''tests''']]
![[Erythema migrans]]
|-
! rowspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Crystal arthritis|Crystal-induced arthritis]]
! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Gout]]<ref name="pmid62879632">{{cite journal |vauthors=Reginato A, Paul H, Schumacher HR |title=Crystal-induced arthritis |journal=Arch Phys Med Rehabil |volume=63 |issue=9 |pages=401–8 |date=September 1982 |pmid=6287963 |doi= |url=}}</ref>
!+
!+/-
!-
!-
!-
!+
!Local [[swelling]] and [[erythema]]
![[Leukocytosis]]
!↑
!Needle shaped [[urate]] crystals, [[WBC]] count > 2000/µL
!Urinary [[uric acid]] (>1100 mg in 24h)
!Punched-out erosions or [[lytic]]<nowiki/>areas with overhanging edges 
!Complementary for recognizing [[Erosion (dental)|erosions]]
![[Tophus|Tophi]] or [[edema]] in [[MRI]]
!Large pale pink acellular areas ([[Uric acid|urate crystals]]), surrounded by [[histiocytes]] and [[multinucleated giant cells]]
![[Synovial fluid]] microscopy
![[Conjunctival|Conjunctival nodules]]
|-
! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Pseudogout|Pseudo-gout]]<ref name="pmid22870500">{{cite journal| author=Macmullan P, McCarthy G| title=Treatment and management of pseudogout: insights for the clinician. | journal=Ther Adv Musculoskelet Dis | year= 2012 | volume= 4 | issue= 2 | pages= 121-31 | pmid=22870500 | doi=10.1177/1759720X11432559 | pmc=3383522 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22870500  }}</ref>
!+
!-
!-
!-
!-
!+/-
!Local [[swelling]] and [[erythema]]
![[Leukocytosis]]
!↑
!Rod shaped [[Calcium pyrophosphate deposition disease|CPPD crystals]], [[WBC]] count > 2000/µL
![[Hypercalcemia]], [[Hypercalciuria]]
!Radiodense lines paralleling the [[articular]] surface and [[calcification]] ([[chondrocalcinosis]])
!Calcific mass with a lobulated configuration in the [[ligamentum flavum]] or the [[joint capsule]]
![[Synovitis]] and [[Calcification|calcific]] deposits in [[ultrasonography]]
!Synovial [[Calcium pyrophosphate|calcium pyrophosphate crystals]]
![[Synovial fluid]] microscopy
![[Tenderness]]
|-
! rowspan="6" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Systemic|Systemic disorders]]
! style="padding: 5px 5px; background: #DCDCDC;" 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>
!+/-
!+/-
!-
!-
!-
!-
![[Genital]] [[ulceration]]
![[Normocytic normochromic anemia]]
!↑
! High [[WBC]] count (10,000-40,000/µL)
! [[HLA-B27|HLA-B27 test]] 
![[Periosteal reaction]] and proliferation of [[Enthesitis|tendon insertion site]]
![[Sacroiliitis]]
![[Enthesitis]] in [[ultrasonography]]
![[Keratoderma blennorrhagica|Keratoderma blennorrhagicum]],[[Balanitis circinata]] 
! [[Spondyloarthritis]] and unequivocal demonstration of preceding infection
![[Conjunctivitis]], [[Uveitis]]
|-
! style="padding: 5px 5px; background: #DCDCDC;" 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>
!+
!-
!-
!-
!-
!+
!Scaly [[Erythematous rash|erythematous plaques]],
[[Guttate psoriasis|Guttate lesions]], Lakes of [[pus]],

[[Erythroderma]]
!Normal
!↑
!High [[WBC]] count (5000-15,000/µL) with >50% of [[PMN|PMN leukocytes]]
!↑[[RF]], [[ANA]], [[IgA]]
![[Joint]]-space narrowing, [[Periostitis|Fluffy periostitis]]
!Pencil-in-cup deformity, Early signs of [[synovitis]]
![[Synovitis|Sacroiliitic synovitis]], [[Enthesitis]] in [[MRI]]
!Lack of intrasynovial [[Immunoglobulin A|Ig]] and [[RF]], Greater propensity for [[Ankylosis|fibrous ankylosis]], [[Osseous|osseous resorption]], and [[Heterotopic ossification|heterotopic bone formation]]
!Clinical findings
![[Onycholysis]], [[Splinter hemorrhage|Splinter hemorrhages]]
|-
! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Inflammatory bowel disease]]-associated [[arthritis]]<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>
!+
!+
!-
!-
!+
!+/-
![[Pyoderma gangrenosum]]([[ulcerative colitis]]),[[Erythema nodosum]]([[Crohn disease]])
![[Iron deficiency anemia]], [[Leukocytosis]], [[Thrombocytosis]]
!↑
!Mild to moderate [[Inflammatory|inflammatory fluid]], [[PMN]]<nowiki/>predominance
!↑[[RF]], [[Endomysium|Antiendomysial Ab]],[[Anti-transglutaminase antibodies|Antitransglutaminase Ab]]
!Bilateral [[sacroiliitis]], Syndesmophytes and apophyseal joint involvement in [[spine]]
!-
!Early detection of [[Spinal stenosis|spinal]] and [[Sacroiliac joint|sacroiliac lesions]] in [[MRI]]
!-
!Clinical findings and history
![[Anterior uveitis|Acute anterior uveitis]]
|-
! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Sarcoidosis|Sarcoid]] periarthritis<ref name="pmid18032765">{{cite journal |vauthors=Iannuzzi MC, Rybicki BA, Teirstein AS |title=Sarcoidosis |journal=N. Engl. J. Med. |volume=357 |issue=21 |pages=2153–65 |date=November 2007 |pmid=18032765 |doi=10.1056/NEJMra071714 |url=}}</ref>
!+
!-
!-
!-
!-
!-
!Mild [[papules]] and [[nodules]]
!Mild [[anemia]]
!↑
!Cell count < 25% [[PMNs]] (non-[[inflammatory]])
! [[IL-2]] and [[Interferon gamma|IFN-γ]], ↑[[Angiotensin-converting enzyme|ACE]], ↑[[Vitamin D|1, 25-dihydroxyvitamin D]]
!Bilateral [[Adenopathy|hilar adenopathy]]
!Active [[alveolitis]] or [[fibrosis]]
![[Hepatosplenomegaly]] in [[ultrasonography]]
![[Granuloma|Noncaseating granulomas (NCGs)]]
![[Histopathology|Histological confirmation]]
![[Heart block]], [[Ocular disease|Ocular lesion]]
|-
! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Rheumatoid arthritis]]<ref name="pmid24024009">{{cite journal| author=Heidari B| title=Rheumatoid Arthritis: Early diagnosis and treatment outcomes. | journal=Caspian J Intern Med | year= 2011 | volume= 2 | issue= 1 | pages= 161-70 | pmid=24024009 | doi= | pmc=3766928 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24024009  }}</ref>
!+
!-
!+
!+
!+
!-
![[Rheumatoid nodules]]
![[Anemia]], [[Thrombocytosis]]
!↑
![[WBC]] count >2000/µL (generally 5000-50,000/µL), with [[neutrophil]]<nowiki/>predominance (60-80%)
![[Anti-citrullinated protein antibody|Anti-CCP Ab]], [[Hyperuricemia]]
![[Joint]]-space narrowing
![[Fractures|Microfractures]]
![[Synovitis]] in [[MRI]]
!Influx of [[inflammatory cells]] into the [[synovial membrane]], with[[angiogenesis]]
!Clinical findings coupled [[Anti-citrullinated protein antibody|anti-CCP antibody]]
![[Rheumatoid nodules]]
|-
! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Myelodysplastic syndrome|Myelodysplastic]] and [[leukemic]] disorders<ref name="pmid24378738">{{cite journal| author=Mekinian A, Braun T, Decaux O, Falgarone G, Toussirot E, Raffray L et al.| title=Inflammatory arthritis in patients with myelodysplastic syndromes: a multicenter retrospective study and literature review of 68 cases. | journal=Medicine (Baltimore) | year= 2014 | volume= 93 | issue= 1 | pages= 1-10 | pmid=24378738 | doi=10.1097/MD.0000000000000011 | pmc=4616329 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24378738  }}</ref>
!+
!+
!+
!+/-
!-
!-
![[Petechia]] and [[purpura]]
![[Anemia]],
[[Leukocytosis]],

[[Thrombocytopenia]]
!↑
![[WBC]] count >2000/µL ([[inflammatory]]), with [[neutrophil]]<nowiki/>predominance
![[LDH]], [[Uric acid]]
![[Articular]] surface erosion, [[Synovial]] effusion
!Thickened [[synovium]]
![[Synovitis]] in [[MRI]]
![[Inflammatory cells]] [[Infiltration (medical)|infiltration]] in synovial tissue
![[Bone marrow biopsy]]
![[Fatigue]], [[Nausea]], Recurrent [[infections]]
|-
|}
</small></small>


==References==
{{reflist|2}}
[[Category:Rheumatology]]