Arthralgia which describes pain in one or more joints with or without joint inflammation, may be present in different health conditions.
DIFFERENTIAL DIAGNOSIS
Osteoarthritis
* Common in Women
* Morning Stiffness, relieved by movements
* Affection of knee, hip and distal IP joints
* Heberden’s nodes
* X Ray – decreased joint space, osteophytes
Rheumatoid arthritis
* Commonly affects women between 20-40 yrs.
* B/L symmetrical involvement of small joints, may spread to large joints
* Signs & markers of inflammation present
* X Ray – decreased joint space, decalcification.
Hemophilic joints
* Common in young boys with positive family history
* Sudden painful B/L hemorrhagic effusion into joints sp. knee
* Increased CT, APPT
* Decreased Factor VIII
Reiter’s disease
* Multiple points affected with acute inflammation
* Associated with non gonococcal urethritis and conjunctivitis
* Common in sexually active males.
Ankylosing Spondylitis
* Common in young males
* Insidious involvement of spinal joints sp. sacroiliac, later developing into kyphosis & ankylosis
Rheumatic Arthritis
* Multiple joints affected with fleeting arthritis
* Evidence of preceding streptococcus haemolyticus infection.
* Associated with carditis, chorea, rheumatic nodules, erythema marginatum.
Gout
* Affects commonly obese man between 25-40 yrs. of age
* Asymmetrical affection of joints, commonly big toe
* Remissions & relapses common.
* Chalky deposits (tophi) may develop in ligaments or ends of bones
* Increased uric acid
Tuberculous arthritis
* Insidious onset
* Commonly affects upper limbs in adults & lower limbs in children
* Raised local temperature, spongy feel of thickened synovial membrane
* Cold abscess & sinus may be present.
Syphilitic arthritis
* Painless, symmetrical arthritis
* Painful swelling occurs in secondary stage
Gonococcal arthritis
* Occurs 3 weeks after primary infection
* Sudden onset with fever
* It may be monoarticular or polyarticular acute arthritis
Typhoid arthritis
* Occurs in 4th week of typhoid fever
Septic arthritis
* Acute onset with symptoms of septicemia