Reactive poststreptococcal arthritis: Difference between revisions
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==Clinical Features== | ==Clinical Features== | ||
*Begins approximately 10d after strep infection (compared to 21d for rheumatic fever) | *Begins approximately 10d after strep infection (compared to 21d for rheumatic fever) | ||
*Arthritis | *[[Arthritis]] | ||
**Generally more severe than that in RF | **Generally more severe than that in RF | ||
**Non-migratory, mono or oligoarthritis | **Non-migratory, mono or oligoarthritis | ||
**ASA-resistant | **ASA-resistant | ||
*Erythema nodosum and erythema multiforme are frequently seen | *[[Erythema nodosum]] and [[erythema multiforme]] are frequently seen | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
Revision as of 22:41, 15 September 2019
Background
- Arthritis of one or more joints after Group A strep pharyngitis
- May represent mild form of rheumatic fever or separate entity
- Not associated with other Major Jones criteria; milder illness than rheumatic fever
Clinical Features
- Begins approximately 10d after strep infection (compared to 21d for rheumatic fever)
- Arthritis
- Generally more severe than that in RF
- Non-migratory, mono or oligoarthritis
- ASA-resistant
- Erythema nodosum and erythema multiforme are frequently seen
Differential Diagnosis
Monoarticular arthritis
- Acute osteoarthritis
- Avascular necrosis
- Crystal-induced (Gout, Pseudogout)
- Gonococcal arthritis, arthritis-dermatitis syndrome
- Nongonococcal septic arthritis
- Lyme disease
- Malignancy (metastases, osteochondroma, osteoid osteoma)
- Reactive poststreptococcal arthritis
- Trauma-induced arthritis
- Fracture
- Ligamentous injury
- Overuse
- Avascular necrosis
- Decompression sickness
- Spontaneous osteonecrosis
- Hemorrhagic (e.g. hemophilia, systemic anticoagulation
- Seronegative spondyloarthropathies (ankylosing spondylitis, IBD, psoriatic arthritis, reactive arthritis
- RA, SLE
- Sarcoidosis, amyloidosis
- Periarticular pathology
- Transient (Toxic) Synovitis (Hip)
- Slipped Capital Femoral Epiphysis (SCFE)
- Legg Calve Perthes Disease
Polyarthritis
- Fibromyalgia
- Juvenile idiopathic arthritis
- Lyme disease
- Osteoarthritis
- Psoriatic arthritis
- Reactive poststreptococcal arthritis
- Rheumatoid arthritis
- Rheumatic fever
- Serum sickness
- Systemic lupus erythematosus
- Serum sickness–like reactions
- Viral arthritis
Evaluation
Management
- Penicillin if GAS is recovered from the throat
- NSAIDs
Disposition
- Discharge