| Monoarthritis | |
|---|---|
| Specialty | Rheumatology  |
Monoarthritis, or monoarticular arthritis, is inflammation ( arthritis ) of one joint at a time (as opposed to oligoarthritis, which affects 2-4 joints, and polyarthritis, which affects more than 4 joints). It is usually caused by trauma, infection, or crystalline arthritis. [1]
Septic arthritis is an inflammatory response to an infection (usually bacterial) in the joint. Usually impacting large joints like the hip or the knee, it is a medical emergency with a mortality rate of about 10%. It is treated with oral and intravenous antibiotics as well as joint drainage. [2]
Gout is inflammation caused by the deposition of needle-shaped monosodium urate crystals in the joints. It is the most common type of inflammatory arthritis in the United States. The disease typically affects a single joint in earlier stages but can progress into polyarthritis over time. It usually occurs in cooler areas of the body, often starting in the big toe. [3]
Pseudogout (also referred to as calcium pyrophosphate dihydrate crystal deposition disease) is another type of crystalline arthritis that presents very similarly to gout but is caused by the deposition of rhomboid-shaped calcium pyrophosphate dihydrate (CPPD) crystals. The knees, wrists, and fingers are the most common joints affected by pseudogout. [3]
Osteoarthritis is a degenerative, or non-inflammatory arthritis. It is the most common type of arthritis, affecting between 19% and 30% of adults above the age of 45. It is caused by a progressive erosion of cartilage which eventually leads to bone damage. It is a polyarthritis, but it usually begins in a single joint. Unlike other types of monoarthritis, which normally have acute onset, onset of osteoarthritis is almost always insidious. [3]
Psoriatic arthritis is an inflammatory arthritis common in people with psoriasis. It often presents as asymmetric oligoarthritis (impacting 2-4 joints) affecting the distal interphalangeal joints, although it can appear in a single joint. Joint-area discoloration, dactylitis, nail changes, and enthesitis, are common symptoms of psoriatic arthritis that distinguish it from other forms of arthritis. Unlike other types of inflammatory arthritis, which typically affect women more than men, psoriatic arthritis has no gender preference. [4]
X-rays, MRI scans, and other types of imaging can show bone loss and erosion from degenerative arthritis or later stages of inflammatory arthritis. Laboratory testing, specifically microscopic synovial fluid examination, is a more accurate method of diagnosing arthritis. By performing a joint aspiration, physicians can check cell counts and look for signs of infection (bacteria/fungus) or crystal formation to determine which, if any, type of arthritis is present. [3]
Monoarthritis is treated the same way as other forms of arthritis. Minimizing pain, preventing disease progression, and improving joint function are the goals of arthritis treatment. Treatment can vary depending on the cause and severity of the condition. Physical therapy, acupuncture, and anti-inflammatory drugs are commonly used to treat the disease. In more severe cases, intra-articular corticosteroid injections or surgical joint replacement may be necessary. Joint drainage and antibiotics are used to treat septic arthritis. Medications that decrease uric acid can mitigate chronic gout symptoms. [3]
Arthritis is a term often used to mean any disorder that affects joints. Symptoms generally include joint pain and stiffness. Other symptoms may include redness, warmth, swelling, and decreased range of motion of the affected joints. In some types of arthritis, other organs are also affected. Onset can be gradual or sudden.
Rheumatology is a branch of medicine devoted to the diagnosis and management of disorders whose common feature is inflammation in the bones, muscles, joints, and internal organs. Rheumatology covers more than 100 different complex diseases, collectively known as rheumatic diseases, which includes many forms of arthritis as well as lupus and Sjögren's syndrome. Doctors who have undergone formal training in rheumatology are called rheumatologists.
A joint or articulation is the connection made between bones, ossicles, or other hard structures in the body which link an animal's skeletal system into a functional whole. They are constructed to allow for different degrees and types of movement. Some joints, such as the knee, elbow, and shoulder, are self-lubricating, almost frictionless, and are able to withstand compression and maintain heavy loads while still executing smooth and precise movements. Other joints such as sutures between the bones of the skull permit very little movement in order to protect the brain and the sense organs. The connection between a tooth and the jawbone is also called a joint, and is described as a fibrous joint known as a gomphosis. Joints are classified both structurally and functionally.
Acute septic arthritis, infectious arthritis, suppurative arthritis, pyogenic arthritis, osteomyelitis, or joint infection is the invasion of a joint by an infectious agent resulting in joint inflammation. Generally speaking, symptoms typically include redness, heat and pain in a single joint associated with a decreased ability to move the joint. Onset is usually rapid. Other symptoms may include fever, weakness and headache. Occasionally, more than one joint may be involved, especially in neonates, younger children and immunocompromised individuals. In neonates, infants during the first year of life, and toddlers, the signs and symptoms of septic arthritis can be deceptive and mimic other infectious and non-infectious disorders.
Psoriatic arthritis (PsA) is a long-term inflammatory arthritis that occurs in people affected by the autoimmune disease psoriasis. The classic feature of psoriatic arthritis is swelling of entire fingers and toes with a sausage-like appearance. This often happens in association with changes to the nails such as small depressions in the nail (pitting), thickening of the nails, and detachment of the nail from the nailbed. Skin changes consistent with psoriasis frequently occur before the onset of psoriatic arthritis but psoriatic arthritis can precede the rash in 15% of affected individuals. It is classified as a type of seronegative spondyloarthropathy.
Synovial fluid, also called synovia,[help 1] is a viscous, non-Newtonian fluid found in the cavities of synovial joints. With its egg white–like consistency, the principal role of synovial fluid is to reduce friction between the articular cartilage of synovial joints during movement. Synovial fluid is a small component of the transcellular fluid component of extracellular fluid.
Polyarthritis is any type of arthritis that involves 5 or more joints simultaneously. It can be associated with autoimmune conditions; it may be experienced at any age and is not sex specific.
Calcium pyrophosphate dihydrate (CPPD) crystal deposition disease, also known as pseudogout and pyrophosphate arthropathy, is a rheumatologic disease which is thought to be secondary to abnormal accumulation of calcium pyrophosphate dihydrate crystals within joint soft tissues. The knee joint is most commonly affected. The disease is metabolic in origin and its treatment remains symptomatic.
An arthropathy is a disease of a joint.
Sacroiliitis is inflammation within the sacroiliac joint. It is a feature of spondyloarthropathies, such as axial spondyloarthritis, psoriatic arthritis, reactive arthritis or arthritis related to inflammatory bowel diseases, including ulcerative colitis or Crohn's disease. It is also the most common presentation of arthritis from brucellosis.
Prepatellar bursitis is an inflammation of the prepatellar bursa at the front of the knee. It is marked by swelling at the knee, which can be tender to the touch and which generally does not restrict the knee's range of motion. It can be extremely painful and disabling as long as the underlying condition persists.
Knee effusion, informally known as water on the knee, occurs when excess synovial fluid accumulates in or around the knee joint. It has many common causes, including arthritis, injury to the ligaments or meniscus, or fluid collecting in the bursa, a condition known as prepatellar bursitis.
Orthopedic pathology, also known as bone pathology is a subspecialty of surgical pathology which deals with the diagnosis and feature of many bone diseases, specifically studying the cause and effects of disorders of the musculoskeletal system. It uses gross and microscopic findings along with the findings of in vivo radiological studies, and occasionally, specimen radiographs to diagnose diseases of the bones.
Arthrocentesis, or joint aspiration, is the clinical procedure performed to diagnose and, in some cases, treat musculoskeletal conditions. The procedure entails using a syringe to collect synovial fluid from or inject medication into the joint capsule. Laboratory analysis of synovial fluid can further help characterize the diseased joint and distinguish between gout, arthritis, and synovial infections such as septic arthritis.
Crystal arthropathy is a class of joint disorder that is characterized by accumulation of tiny crystals in one or more joints. Polarizing microscopy and application of other crystallographic techniques have improved identification of different microcrystals including monosodium urate, calcium pyrophosphate dihydrate, calcium hydroxyapatite, and calcium oxalate.
Milwaukee shoulder syndrome (MSS) (apatite-associated destructive arthritis/Basic calcium phosphate (BCP) crystal arthritis/rapid destructive arthritis of the shoulder is a rare rheumatological condition similar to pseudogout, associated with periarticular or intra-articular deposition of hydroxyapatite or basic calcium phosphate (BCP) crystals. While primarily associated with the shoulder joint, it can affect any joint in the body below the head. Along with symptomatology, the disease typically presents with positive radiologic findings, often showing marked erosion of the humeral head, cartilage, capsule, and bursae. Though rare, it is most often seen in females beginning in their 50s or 60s. Patients often have a history of joint trauma or overuse, calcium pyrophosphate dehydrate crystal deposition, neuroarthropathy, dialysis-related arthropathy or denervation.
Enteropathic arthropathy commonly referred to as enteropathic arthritis, is a type of arthritis linked to Crohn's disease, ulcerative colitis, and chronic inflammatory bowel diseases.
Chondrocalcinosis or cartilage calcification is calcification in hyaline cartilage and/or fibrocartilage. Chondrocalcinosis is an observation that can be visualized through diagnostic imaging tests such as X-rays, CT, MRI, and ultrasound.
Crystallopathy is a harmful state or disease associated with the formation and aggregation of crystals in tissues or cavities, or in other words, a heterogeneous group of diseases caused by intrinsic or environmental microparticles or crystals, promoting tissue inflammation and scarring.
Acquired hand deformity refers to the structural or functional abnormalities that develop in the hand. There are multiple varying causes of acquired hand deformity, triggering significant consequences and complications. Trauma, including blunt force, penetrating injuries, burns, and sports-related incidents, is a primary cause of acquired hand deformities. Inflammatory conditions such as rheumatoid arthritis, gouty arthritis, and systemic lupus erythematosus can also contribute to hand deformities by affecting the joints. Degenerative arthritis, specifically osteoarthritis, functions to evoke impaired hand function due to the gradual deterioration of cartilage. Neurological disorders like cerebral palsy can result in hand contractures due to increased muscle tone and stiffness. There are different types of acquired hand deformities, each with distinct characteristics and underlying causes, such as boutonnière deformity, Dupuytren's contracture, gamekeeper's thumb, hand osteoarthritis deformity, mallet finger, swan-neck deformity, ulnar claw hand, among many others.
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