Monoarticular arthritis - Revision history

Danbot: Add verified PubMed references (PMIDs 22670394, 33971340)

2026-03-22T10:49:44Z

Add verified PubMed references (PMIDs 22670394, 33971340)

← Older revision		Revision as of 10:49, 22 March 2026
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	==Background==		==Background==
	*Monoarticular arthritis (monoarthritis) refers to inflammation of a single joint		*Monoarticular arthritis (monoarthritis) refers to inflammation of a single joint<ref>Genes N, Chisolm-Straker M. Monoarticular arthritis update: Current evidence for diagnosis and treatment in the emergency department. Emerg Med Pract. 2012 May;14(5):1-19; quiz 19-20. PMID 22670394</ref>
	*The critical EM question is: Is this septic arthritis?		*The critical EM question is: Is this septic arthritis?
	*Septic arthritis is a joint emergency requiring urgent drainage — delay increases risk of joint destruction		*Septic arthritis is a joint emergency requiring urgent drainage — delay increases risk of joint destruction
	*Other common causes include crystal arthropathy ([[gout]], [[pseudogout]]) and traumatic hemarthrosis		*Other common causes include crystal arthropathy ([[gout]], [[pseudogout]]) and traumatic hemarthrosis<ref>Keret S, et al. Approach to a patient with monoarticular disease. Autoimmun Rev. 2021 Jul;20(7):102848. PMID 33971340</ref>
	*[[Arthrocentesis]] is the key diagnostic procedure and should be performed on any hot, swollen joint without clear alternative diagnosis		*[[Arthrocentesis]] is the key diagnostic procedure and should be performed on any hot, swollen joint without clear alternative diagnosis

Danbot: Strip excess bold

2026-03-22T09:31:34Z

Strip excess bold

← Older revision		Revision as of 09:31, 22 March 2026
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	==Background==		==Background==
	*Monoarticular arthritis (monoarthritis) refers to inflammation of a single joint		*Monoarticular arthritis (monoarthritis) refers to inflammation of a single joint
	*The critical EM question is: ~~'''~~Is this septic arthritis?~~'''~~		*The critical EM question is: Is this septic arthritis?
	*Septic arthritis is a joint emergency requiring urgent drainage — delay increases risk of joint destruction		*Septic arthritis is a joint emergency requiring urgent drainage — delay increases risk of joint destruction
	*Other common causes include crystal arthropathy ([[gout]], [[pseudogout]]) and traumatic hemarthrosis		*Other common causes include crystal arthropathy ([[gout]], [[pseudogout]]) and traumatic hemarthrosis
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	===Synovial Fluid Analysis===		===Synovial Fluid Analysis===
	{{Arthrocentesis diagnostic chart}}		{{Arthrocentesis diagnostic chart}}
	*~~'''~~WBC >50,000/mm³ with >90% PMNs~~'''~~: highly suggestive of septic arthritis		*WBC >50,000/mm³ with >90% PMNs: highly suggestive of septic arthritis
	*~~'''~~Crystals~~'''~~: negatively birefringent (gout), positively birefringent (pseudogout)		*Crystals: negatively birefringent (gout), positively birefringent (pseudogout)
	*Note: crystals and infection can coexist — always send culture even if crystals present		*Note: crystals and infection can coexist — always send culture even if crystals present
	*Gram stain: positive in ~50% of non-gonococcal septic arthritis		*Gram stain: positive in ~50% of non-gonococcal septic arthritis
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	==Management==		==Management==
	===Septic Arthritis===		===Septic Arthritis===
	*~~'''~~Emergent orthopedic consultation~~'''~~ for surgical drainage/washout		*Emergent orthopedic consultation for surgical drainage/washout
	*Empiric IV antibiotics after arthrocentesis:		*Empiric IV antibiotics after arthrocentesis:
	**[[Vancomycin]] (MRSA coverage) for most patients		**[[Vancomycin]] (MRSA coverage) for most patients
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	===Crystal Arthropathy===		===Crystal Arthropathy===
	*~~'''~~[[Gout]]~~'''~~: NSAIDs ([[indomethacin]], [[naproxen]]), [[colchicine]], or [[corticosteroids]] (PO or intra-articular)		*[[Gout]]: NSAIDs ([[indomethacin]], [[naproxen]]), [[colchicine]], or [[corticosteroids]] (PO or intra-articular)
	*~~'''~~[[Pseudogout]]~~'''~~: NSAIDs, [[colchicine]], or intra-articular/systemic corticosteroids		*[[Pseudogout]]: NSAIDs, [[colchicine]], or intra-articular/systemic corticosteroids
	*Avoid [[allopurinol]] initiation or changes during acute flare		*Avoid [[allopurinol]] initiation or changes during acute flare

Danbot: Expanded with EM-focused content: septic arthritis red flags, arthrocentesis guidance, synovial fluid analysis, management, disposition

2026-03-20T23:26:22Z

Expanded with EM-focused content: septic arthritis red flags, arthrocentesis guidance, synovial fluid analysis, management, disposition

@@ Line 1: / Line 1: @@
 ==Background==
 ==Clinical Features==
 ==Differential Diagnosis==
@@ Line 24: / Line 52: @@
 *[[Decompression sickness]]
 *Spontaneous osteonecrosis
-**pain in absence of trauma
+**Pain in absence of trauma
-**femoral head, medial conyle of knee
+**Femoral head, medial condyle of knee
 ===Hemorrhagic===
@@ Line 43: / Line 71: @@
 *Seronegative (no RF) spondyloarthropathies ([[ankylosing spondylitis]], [[IBD]], [[psoriatic arthritis|psoriatic]], [[reactive arthritis]])
 *[[Rheumatoid arthritis]], [[SLE]]
-===Periarticular (mimic joint involvement)===
+===Periarticular (Non-Articular)===
 *[[Cellulitis]]
-===Pediatric===
+==Evaluation==
-*[[Transient (Toxic) Synovitis (Hip)]]
+===Arthrocentesis (Key Diagnostic Study)===
-*[[Slipped Capital Femoral Epiphysis (SCFE)]]
+*Perform [[arthrocentesis]] on any acute hot, swollen joint unless clear alternative diagnosis
-*[[Legg Calve Perthes Disease]]
+*'''Do not delay arthrocentesis for imaging'''
-==Evaluation==
+===Imaging===
 ==Management==
 ==Disposition==
 ==See Also==
 *[[Pseudogout]]
-*[[Gout]]
+*[[Arthrocentesis]]
-*[[Septic Arthritis (Hip)]]
+*[[Gonococcal arthritis]]
-*[[Septic Arthritis (General)]]
-*[[Arthritis]]
+==External Links==
 ==References==
 <references/>
 [[Category:Orthopedics]]
 [[Category:Rheumatology]]

ClaireLewis at 23:48, 17 October 2019

2019-10-17T23:48:24Z

← Older revision		Revision as of 23:48, 17 October 2019
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	[[Category:Orthopedics]]		[[Category:Orthopedics]]
	[[Category:Rheumatology]]		[[Category:Rheumatology]]
			[[Category:Symptoms]]

ClaireLewis: /* Septic Arthritis */

2019-08-29T15:59:18Z

Septic Arthritis

← Older revision		Revision as of 15:59, 29 August 2019
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	===[[Septic Arthritis]]===		===[[Septic Arthritis]]===
	*[[Gonococcal ~~Arthritis~~]]		*[[Gonococcal arthritis]]
	*Nongonococcal Arthritis		*Nongonococcal Arthritis
	*Arthritis-Dermatitis Syndrome		*Arthritis-Dermatitis Syndrome

ClaireLewis at 15:59, 29 August 2019

2019-08-29T15:59:01Z

← Older revision		Revision as of 15:59, 29 August 2019
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	===[[Septic Arthritis]]===		===[[Septic Arthritis]]===
	*Gonococcal Arthritis		*[[Gonococcal Arthritis]]
	*Nongonococcal Arthritis		*Nongonococcal Arthritis
	*Arthritis-Dermatitis Syndrome		*Arthritis-Dermatitis Syndrome
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	===Traumatic===		===Traumatic===
	*Fracture		*[[Fracture]]
	*~~ligamentous~~		*Ligamentous injury
	*Overuse		*Overuse

	===Ischemic===		===Ischemic===
	*Avascular necrosis		*[[Avascular necrosis]]
	*Decompression ~~illness~~		*[[Decompression sickness]]
	*Spontaneous osteonecrosis		*Spontaneous osteonecrosis
	*pain in ~~abscence~~ of trauma		**pain in absence of trauma
	*femoral head, medial conyle of knee		**femoral head, medial conyle of knee

	===Hemorrhagic===		===Hemorrhagic===
	*Posttraumatic		*Posttraumatic
	*Hemophilia		*[[Hemophilia]]
	*Systemic anticoagulation		*Systemic [[anticoagulation]]

	===Neoplastic===		===Neoplastic===
	*~~Mets~~		*Metastases
	*Osteochondroma		*Osteochondroma
	*Osteoid osteoma		*Osteoid osteoma
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	===Systemic Disease===		===Systemic Disease===
	*Remote ~~infectionn~~, infectious endocarditis		*Remote infection, infectious [[endocarditis]]
	*Rheumatic fever		*[[Rheumatic fever]]
	*Seronegative (no RF) spondyloarthropathies (AS, ~~IBS~~, psoriatic, reactive ~~or Reiter's~~)		*Seronegative (no RF) spondyloarthropathies ([[ankylosing spondylitis]], [[IBD]], [[psoriatic arthritis\|psoriatic]], [[reactive arthritis]])
	*Rheumatoid arthritis, SLE		*[[Rheumatoid arthritis]], [[SLE]]
	*Sarcoidosis, amyloidosis		*[[Sarcoidosis]], [[amyloidosis]]

	===Periarticular (mimic joint involvement)===		===Periarticular (mimic joint involvement)===
	*Cellulitis		*[[Cellulitis]]
	*Tendonitis		*Tendonitis
	*Bursitis		*[[Bursitis]]

	===Pediatric===		===Pediatric===

Mholtz: Text replacement - "==References== " to "==References== "

2017-07-24T01:12:48Z

Text replacement - "==References== " to "==References== <references/> "

← Older revision		Revision as of 01:12, 24 July 2017
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	==References==		==References==
			<references/>
	[[Category:Orthopedics]]		[[Category:Orthopedics]]
	[[Category:Rheumatology]]		[[Category:Rheumatology]]

Neil.m.young: Text replacement - "==Diagnosis==" to "==Evaluation=="

2016-07-22T11:35:27Z

Text replacement - "==Diagnosis==" to "==Evaluation=="

← Older revision		Revision as of 11:35, 22 July 2016
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	*[[Legg Calve Perthes Disease]]		*[[Legg Calve Perthes Disease]]

	==~~Diagnosis~~==		==Evaluation==

	==Management==		==Management==

Rossdonaldson1: Text replacement - "infx" to "infection"

2016-07-08T16:01:27Z

Text replacement - "infx" to "infection"

← Older revision		Revision as of 16:01, 8 July 2016
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	===Systemic Disease===		===Systemic Disease===
	*Remote ~~infxn~~, infectious endocarditis		*Remote infectionn, infectious endocarditis
	*Rheumatic fever		*Rheumatic fever
	*Seronegative (no RF) spondyloarthropathies (AS, IBS, psoriatic, reactive or Reiter's)		*Seronegative (no RF) spondyloarthropathies (AS, IBS, psoriatic, reactive or Reiter's)

Ostermayer: Text replacement - "Category:Rheum" to "Category:Rheumatology"

2016-03-22T16:17:10Z

Text replacement - "Category:Rheum" to "Category:Rheumatology"

← Older revision		Revision as of 16:17, 22 March 2016
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	[[Category:Orthopedics]]		[[Category:Orthopedics]]
	[[Category:~~Rheum~~]]		[[Category:Rheumatology]]