Polyarthritis

CLINICAL DIAGNOSTIC MANUAL

Polyarthritis is a condition characterised by the inflammation of multiple joints simultaneously. It can be acute or chronic and affects people of all ages. Polyarthritis may be a symptom of various diseases, including viral infections, autoimmune diseases, and drug reactions. Accurate identification of the underlying cause is crucial for proper management and effective treatment of this condition.

Condition	Symptoms and Clinical Signs	Suspected Diagnosis	Confirmatory Diagnosis
Viral Infection	Joint pain, fever, general malaise, respiratory or gastrointestinal symptoms	History of recent viral symptoms	Viral serologies, PCR for specific viruses
Rheumatoid Arthritis	Morning pain and stiffness in small and large joints, rheumatoid nodules	History of symmetrical joint pain and prolonged morning stiffness	Positive RF, positive anti-CCP, X-rays showing joint erosions
Sjögren’s Syndrome	Joint pain, dry eyes and mouth, fatigue	History of dryness symptoms, joint pain	Positive ANA, positive anti-Ro/SSA and anti-La/SSB, salivary gland biopsy
Rheumatic Fever	Migratory polyarthritis, fever, carditis, subcutaneous nodules, erythema marginatum	History of recent pharyngeal infection, migratory symptoms	Jones criteria, positive throat culture for streptococcus
Systemic Lupus Erythematosus (SLE)	Joint pain, skin rashes, fatigue, fever, multisystem symptoms	History of systemic and cutaneous symptoms	Positive ANA, positive anti-dsDNA, skin or kidney biopsy
Ulcerative Colitis	Joint pain, bloody diarrhea, abdominal pain, weight loss	History of gastrointestinal and joint symptoms	Colonoscopy with biopsy, elevated inflammatory markers
Crohn’s Disease	Joint pain, diarrhea, abdominal pain, weight loss, fever	History of chronic gastrointestinal symptoms and joint pain	Colonoscopy with biopsy, intestinal imaging (CT, MRI)
Drug-Induced Reaction	Joint pain, skin rash, fever, systemic symptoms	History of new medication initiation before symptom onset	Symptom resolution after discontinuing the drug, allergy testing if needed
Reiter’s Syndrome (Reactive Arthritis)	Joint pain, eye inflammation (conjunctivitis, uveitis), urethritis	History of prior infection and symptoms of arthritis, urethritis, and conjunctivitis	Synovial fluid analysis, infection testing (cultures, PCR), positive HLA-B27
Psoriasis	Joint pain and inflammation, presence of psoriatic skin lesions	History of psoriasis, articular symptoms	Clinical analysis of skin lesions and joint symptoms