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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Eiman Ghaffarpasand, M.D. [2]
Diseases
|
Clinical manifestations
|
Para-clinical findings
|
Gold standard
|
Additional findings
|
Symptoms
|
Physical examination
|
Lab Findings
|
Imaging
|
Histopathology
|
Joint Swelling
|
Fever
|
Weight loss
|
Claudication
|
Morning stiffness
|
Local erythema
|
Skin manifestation
|
CBC
|
ESR
|
Synovial fluid
|
Other
|
X-ray
|
CT scan
|
Other
|
Polyarthritis
|
Infectious arthritis
|
Lyme disease[1]
|
+
|
+
|
+/-
|
+/-
|
-
|
-
|
Erythema migrans
|
Leukopenia, Thrombocytopenia
|
-
|
Cell counts 500-98,000/µL
|
Microscopic hematuria, Proteinuria, ↑ALT or AST
|
-
|
-
|
-
|
Fibrosis of the deeper dermis and hyalinization of collagen bundles
|
Serologic tests
|
Erythema migrans
|
Bacterial endocarditis[2]
|
+
|
+
|
+
|
-
|
-
|
+/-
|
Janeway lesions, Osler nodes, Roth spots
|
Normochromic-normocytic anemia
|
↑
|
↑WBC, S. aureus in culture
|
Hyperglobulinemia, Cryoglobulinemia
|
Joint erosion and effusion
|
-
|
-
|
Vegetation or intracardiac abscess demonstrating active endocarditis
|
Echocardiography (TTE)
|
Vertebral osteomyelitis
|
Postinfectious (reactive) arthritis
|
Rheumatic fever[3]
|
+
|
+
|
-
|
-
|
-
|
+/-
|
Erythema marginatum rheumaticum
|
Leukocytosis
|
↑
|
Sterile inflammatory reaction with cells<20,000/μL
|
Streptococcal antibody titer
|
Cardiomegaly
|
Valvular or pericardial calcification
|
Echocardiographic changes in heart valves
|
Edema, Fibrinoid necrosis, Mononuclear cell infiltrate
|
Echocardiography
|
Chorea, Carditis
|
Reactive arthritis[4]
|
+/-
|
+/-
|
-
|
-
|
-
|
-
|
Genital ulceration
|
Normocytic normochromic anemia
|
↑
|
High WBC count (10,000-40,000/µL)
|
HLA-B27 test
|
Periosteal reaction and proliferation of tendon insertion site
|
Sacroiliitis
|
Enthesitis in ultrasonography
|
Keratoderma blennorrhagicum, Balanitis circinata
|
Spondyloarthritis and unequivocal demonstration of preceding infection
|
Conjunctivitis, Uveitis
|
Other seronegative spondyloarthritides
|
Ankylosing spondylitis[5]
|
+
|
-
|
+/-
|
+/-
|
+
|
-
|
Dactylitis (sausage digit)
|
Normocytic normochromic anemia
|
↑
|
High WBC count (lymphocyte predominance)
|
↑Alkaline phosphatase (ALP)
|
Bony erosions and sclerosis of the joints
|
Early sacroiliitis, erosions, and enthesitis
|
Possible cauda equina syndrome secondary to spinal stenosis in MRI
|
Chronic inflammation with CD4+ and CD8+ T lymphocytes and macrophages
|
Plain x-rays
|
Peripheral enthesitis, Uveitis
|
Psoriatic arthritis[6]
|
+
|
-
|
-
|
-
|
-
|
+
|
Scaly erythematous plaques,
Guttate lesions, Lakes of pus,
Erythroderma
|
Normal
|
↑
|
High WBC count (5000-15,000/µL) with >50% of PMN leukocytes
|
↑RF, ANA, IgA
|
Joint-space narrowing, Fluffy periostitis
|
Pencil-in-cup deformity, Early signs of synovitis
|
Sacroiliitic synovitis, Enthesitis in MRI
|
Lack of intrasynovial Ig and RF, Greater propensity for fibrous ankylosis, osseous resorption, and heterotopic bone formation
|
Clinical findings
|
Onycholysis, Splinter hemorrhages
|
Inflammatory bowel disease[7]
|
+
|
+
|
-
|
-
|
+
|
+/-
|
Pyoderma gangrenosum (ulcerative colitis), Erythema nodosum (Crohn disease)
|
Iron deficiency anemia, Leukocytosis, Thrombocytosis
|
↑
|
Mild to moderate inflammatory fluid, PMN predominance
|
↑RF, Antiendomysial Ab, Antitransglutaminase Ab
|
Bilateral sacroiliitis, Syndesmophytes and apophyseal joint involvement in spine
|
-
|
Early detection of spinal and sacroiliac lesions in MRI
|
-
|
Clinical findings and history
|
Acute anterior uveitis
|
Rheumatoid arthritis[8]
|
+
|
-
|
+
|
+
|
+
|
-
|
Rheumatoid nodules
|
Anemia, Thrombocytosis
|
↑
|
WBC count >2000/µL (generally 5000-50,000/µL), with neutrophil predominance (60-80%)
|
Anti-CCP Ab, Hyperuricemia
|
Joint-space narrowing
|
Microfractures
|
Synovitis in MRI
|
Influx of inflammatory cells into the synovial membrane, with angiogenesis
|
Clinical findings coupled anti-CCP antibody
|
Rheumatoid nodules
|
Crystal-induced arthritis[9]
|
+
|
+/-
|
-
|
-
|
-
|
+
|
Joint erythema
|
Leukocytosis
|
↑
|
Needle shaped urate crystals, WBC count > 2000/µL
|
Urinary uric acid (>1100 mg in 24h)
|
Punched-out erosions or lytic areas with overhanging edges
|
Complementary for recognizing erosions
|
Tophi or edema in MRI
|
Large pale pink acellular areas (urate crystals), surrounded by histiocytes and multinucleated giant cells
|
Synovial fluid assay
|
Conjunctival nodules
|
Systemic rheumatic illnesses
|
Systemic lupus erythematosus[10]
|
+
|
-
|
+/-
|
-
|
-
|
+
|
Malar rash, Photosensitivity, Discoid lupus
|
Leukopenia, Lymphopenia, Anemia, Thrombocytopenia
|
↑
|
Cell count from < 25% PMNs (non-inflammatory effusions) to > 50% PMNs (inflammatory effusions)
|
Creatine kinase, LFT, ANA, Anti-dsDNA, Anti-Sm, Lupus anticoagulant
|
Periarticular osteopenia and soft-tissue swelling without erosions
|
Interstitial lung disease, Pneumonitis, Pulmonary emboli, Alveolar hemorrhage
|
Pericardial effusion, Pulmonary hypertension, Verrucous Libman-Sacks endocarditis in echocardiography
|
Inflammatory infiltrates at the dermoepidermal junction and vacuolar change in the basal columnar cells
|
Anti-dsDNA
|
Rheumatoid arthritis, Serositis, Oral ulcers
|
Behçet's syndrome[11]
|
+
|
-
|
-
|
-
|
-
|
-
|
Erythema nodosum
|
Normocytic normochromic anemia
|
↑
|
Cell count < 25% PMNs (non-inflammatory)
|
Serum complement levels, Human leukocyte antigen (HLA)-B51
|
Soft tissue swelling
|
Non-erosive synovitis
|
-
|
Dermal vessels infiltration with lymphocytes and plasma cells, Immune deposits of immunoglobulin M (IgM) and C3
|
Clinical findings
|
Oral ulcer, Mucosal erosion
|
Relapsing polychondritis[12]
|
+
|
-
|
-
|
-
|
-
|
-
|
-
|
Leukocytosis, Anemia
|
-
|
Cell count < 25% PMNs (non-inflammatory)
|
Cryoglobulins, ANA, C-ANCA
|
Tracheal stenosis in CXR
|
Calcification of cartilaginous structures
|
Aortic root dilatation and degree of aortic regurgitation in echocardiography
|
Chondrolysis, Chondritis, Perichondritis
|
Clinical findings coupled with imaging
|
Ear pain and redness, Polyarthritis
|
Other systemic illnesses
|
Sarcoidosis[13]
|
+
|
-
|
-
|
-
|
-
|
-
|
Mild papules and nodules
|
Mild anemia
|
↑
|
Cell count < 25% PMNs (non-inflammatory)
|
IL-2 and IFN-γ, ↑ACE, ↑1, 25-dihydroxyvitamin D
|
Bilateral hilar adenopathy
|
Active alveolitis or fibrosis
|
Hepatosplenomegaly in ultrasonography
|
Noncaseating granulomas (NCGs)
|
Histological confirmation
|
Heart block, Ocular lesion
|
Palindromic rheumatism[14]
|
+
|
-
|
-
|
+/-
|
+
|
-
|
Rheumatoid nodules
|
Anemia
|
↑
|
High WBC count (5000-15,000/µL) with >50% of PMN leukocytes
|
RF, Anti-CCP antibody, ↑Cr or BUN,
↑ALT or AST, ANA
|
Effusions in joints
|
Microfractures
|
Basilar invagination with cranial migration of an eroded odontoid peg in MRI
|
Influx of inflammatory cells into the synovial membrane, withangiogenesis, proliferation of chronic inflammatory cells
|
Clinical findings coupled anti-CCP antibody
|
Rheumatoid nodules
|
Polyarticular pain
|
Viral arthritis
|
Parvovirus[15]
|
+
|
+
|
+/-
|
-
|
-
|
-
|
Fifth disease/ Erythema infectiosum
|
Aplastic crisis
|
↑
|
Normal
|
ANA, RF, CRP
|
Joint swelling
|
-
|
-
|
Immune complex deposition
|
Parvovirus IgM antibody
|
Transient aplastic crisis, Fetal infection
|
Soft tissue abnormalities
|
+
|
-
|
-
|
-
|
-
|
+/-
|
Maculopapular rash
|
Normal
|
-
|
Cell count < 25% PMNs (non-inflammatory)
|
CRP, Ca
|
Joint swelling
|
Synovial edema and thickness
|
Mild joint effusion in ultrasonography
|
Mild inflammation
|
Clinical findings
|
Mucositis, Enthesitis
|
- ↑ Lantos PM (2015). "Chronic Lyme disease". Infect Dis Clin North Am. 29 (2): 325–40. doi:10.1016/j.idc.2015.02.006. PMC 4477530. PMID 25999227.
- ↑ Soor P, Sharma N, Rao C (2017). "Multifocal Septic Arthritis Secondary to Infective Endocarditis: A Rare Case Report". J Orthop Case Rep. 7 (1): 65–68. doi:10.13107/jocr.2250-0685.692. PMC 5458702. PMID 28630844.
- ↑ Kumar RK, Tandon R (2013). "Rheumatic fever & rheumatic heart disease: the last 50 years". Indian J Med Res. 137 (4): 643–58. PMC 3724245. PMID 23703332.
- ↑ Colmegna I, Cuchacovich R, Espinoza LR (2004). "HLA-B27-associated reactive arthritis: pathogenetic and clinical considerations". Clin Microbiol Rev. 17 (2): 348–69. PMC 387405. PMID 15084505.
- ↑ McVeigh CM, Cairns AP (2006). "Diagnosis and management of ankylosing spondylitis". BMJ. 333 (7568): 581–5. doi:10.1136/bmj.38954.689583.DE. PMC 1570004. PMID 16974012.
- ↑ Sankowski AJ, Lebkowska UM, Cwikła J, Walecka I, Walecki J (2013). "Psoriatic arthritis". Pol J Radiol. 78 (1): 7–17. doi:10.12659/PJR.883763. PMC 3596149. PMID 23493653.
- ↑ Orchard TR (2012). "Management of arthritis in patients with inflammatory bowel disease". Gastroenterol Hepatol (N Y). 8 (5): 327–9. PMC 3424429. PMID 22933865.
- ↑ Heidari B (2011). "Rheumatoid Arthritis: Early diagnosis and treatment outcomes". Caspian J Intern Med. 2 (1): 161–70. PMC 3766928. PMID 24024009.
- ↑ Reginato A, Paul H, Schumacher HR (September 1982). "Crystal-induced arthritis". Arch Phys Med Rehabil. 63 (9): 401–8. PMID 6287963.
- ↑ Manson JJ, Rahman A (2006). "Systemic lupus erythematosus". Orphanet J Rare Dis. 1: 6. doi:10.1186/1750-1172-1-6. PMC 1459118. PMID 16722594.
- ↑ Sugawara S, Ehara S, Hitachi S, Sugimoto H (March 2010). "Hand and wrist arthritis of Behçet disease: imaging features". Acta Radiol. 51 (2): 183–6. doi:10.3109/02841850903401349. PMID 20121672.
- ↑ Emmungil H, Aydın SZ (2015). "Relapsing polychondritis". Eur J Rheumatol. 2 (4): 155–159. doi:10.5152/eurjrheum.2015.0036. PMC 5047229. PMID 27708954.
- ↑ Iannuzzi MC, Rybicki BA, Teirstein AS (November 2007). "Sarcoidosis". N. Engl. J. Med. 357 (21): 2153–65. doi:10.1056/NEJMra071714. PMID 18032765.
- ↑ Iyer VR, Cohen GL (February 2011). "Palindromic rheumatism". South. Med. J. 104 (2): 147–9. doi:10.1097/SMJ.0b013e318200c4cc. PMID 21206416.
- ↑ Moore TL (July 2000). "Parvovirus-associated arthritis". Curr Opin Rheumatol. 12 (4): 289–94. PMID 10910181.