MANUAL MINORS
Viral arthritis is a transient inflammation of the joints caused by viral infections. It typically affects multiple joints (polyarthritis) and presents with pain, swelling, and joint stiffness. The most commonly implicated viruses include parvovirus B19, hepatitis B and C viruses, chikungunya virus,
Zika virus, and Epstein-Barr virus. This condition is self-limiting and usually resolves within a few weeks without causing long-term joint damage.
Diagnosis
Diagnosis is based on the clinical history of a recent or current viral infection, along with the acute onset of arthritis. Symptoms include joint pain, swelling, and, in some cases, fever or rash.
Laboratory tests may show mild inflammatory markers, but serological studies are key to identifying the responsible virus (IgM, IgG antibodies or viral PCR). Synovial fluid analysis is typically sterile, with no signs of bacterial infection.
Differential Diagnosis
Condition | Distinctive Features |
|---|---|
Rheumatoid arthritis | Chronic polyarthritis, positive serological tests (RF, anti-CCP), prolonged morning stiffness. |
Septic arthritis | High fever, severe pain, purulent synovial fluid, positive culture. |
Rheumatic fever | History of streptococcal pharyngitis, carditis, erythema marginatum, chorea. |
Reactive arthritis | History of prior infection, especially gastrointestinal or urinary, affecting large joints. |
Gout | Acute attacks, presence of urate crystals in synovial fluid, usually monoarticular. |
Emergency Management
Emergency management of viral arthritis is primarily symptomatic, as the condition is usually self-limiting. Analgesics such as paracetamol or nonsteroidal anti-inflammatory drugs (NSAIDs) are administered to control pain and inflammation.
In cases of severe joint pain or fever, it may be necessary to rule out other infectious or inflammatory causes through synovial fluid studies and serological tests. Invasive interventions are generally not required, and hospitalisation is rare, except in cases of severe complications.
Definitive Treatment
Definitive treatment focuses on resolving the underlying viral infection, if needed. In most cases, viral arthritis resolves spontaneously within a few weeks. Joint rest and clinical follow-up are recommended. Disease-modifying drugs are not necessary unless the arthritis persists or there is an underlying condition.
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