There are a number of causes, with crystals, trauma and infection being the most common. If so, share your ppt presentation slides online with. Transient synovitis of the hip is fairly characteristic but rarely investigated by joint aspiration. When dealing with a single joint location, need to check to make sure it is actually arthritis, as you need to consider the following. Acute monoarthritis inflammatory process involving a single joint develops over a few days any rheumatic disease can present as monoarthritis monoarthritis is not the initial symptom of a systemic connective tissue disease.
However, in a significant minority of patients there will be no history of trauma and consequently a different approach to assessment and investigation is required. The main symptoms of arthritis are joint pain and stiffness, which typically worsen with age. Septic arthritis must be always be considered and excluded in any monoarthritis. Acute monoarthritis is a rheumatologic emergency acute monoarthritis should always be assumed to be caused by an infection. Assessment, investigation, and management of monoarthritis. Convert and create pdf from various types of files like word doc, excel xls, powerpoint ppt. A read is counted each time someone views a publication summary such as the title, abstract, and list of authors, clicks on a figure, or views or downloads the fulltext. Our aim is to offer an outline of how to assess, investigate, and manage a patient with. Objectives understand the definition and epidemiology of uncomplicated, nonpurulent cellulitis. No studies that evaluated patient history or findings from physical examination met our inclusion criteria. Gonococcal arthritis is the most common type of nontraumatic monoarthritis in young, sexuallyactive young adults. Pigmented villonodular synovitis is usually seen in young adults, with a peak presentation between the 3rd and 4th decades of life. Oligojia affects one to four joints within the first 6 months of disease. A 70yearold male patient presented with pain and restriction of movements of his left wrist.
Persistent inflammatory monoarthritis is inflammation of one joint, with symptoms lasting beyond 3 months. Monoarthritis in a young adult should raise the possibility of rea. Common septic arthritis osteoarthritis posttraumatic gout charcot joint neuropathic joint pigmented villonodular synovitis pvns synovial osteochondromatos. If you wanna take it down, feel free to let me know. Apr 30, 2017 precise diagnosis of the underlying cause of monoarthritis relies on a good history, physical examination findings, and results of focused investigations. Dr mcgill is a clinical associate professor in the department of medicine at the university of sydney and a consultant rheumatologist at royal prince alfred hospital. A detailed history and clinical examination is important to reach a correct diagnosis and. Approach to acute monoarthritis is the property of its rightful owner. Gout can cause mono or polyarthritis, but usually results in monoarthritis first. Acute monoarthritis is joint inflammation arthritis of one joint.
Understand the most common microbial causes of nonpurulent cellulitis. Polyarticular conditions can present initially with a single inflamed joint. Pdf isolated knee monoarthritis heralding resectable non. Rheumatoid arthritis with monoarthritic presentation. Part ofthe aim ofthe series is to engage the readership in continuing medical education cme continuing professional development cpd. Jul 19, 2019 arthritis is the swelling and tenderness of one or more of your joints. Monoarthritis differential radiology reference article. Diagnosing acute monoarthritis in adults free download as pdf file.
What should we always assume is the cause until proven otherwise. A free powerpoint ppt presentation displayed as a flash slide show on id. Read the medical definition of monoarthritis, arthritis that occurs in only one joint at a time. Ppt approach to acute monoarthritis powerpoint presentation. Rheumatoid arthritis reiters syndromereactive arthritis juvenile rheumatoid arthritis psoriatic arthritis viral arthritis enteropathic arthritis sarcoid arthritis whipples disease the most likely causes of chronic monoarthritis inflammation within a single joint for 6 weeks. Jul 28, 2019 monoarthritis may be a result of infection e. Monoarthritis is a common clinical presentation in general medical and rheumatology practices. Synovial fluid examination is the most important investigation. The patients were seen over a 12month period in an acute arthritis clinic in glasgow, scotland. Joint infection or trauma to a joint causes acute monoarthritis.
In 2006, the european league against rheumatism developed evidencebased recommendations for the diagnosis of gout. Investigation of acute monoarthritis summary radiology. Indy ghosh discuss the difficult diagnostic dilemmas when faced with a patient with acute monoarthritis. Jan 11, 2017 acute monoarthritis is joint inflammation arthritis of one joint.
Night pain, morning stiffness, systemic symptoms, recent nonarticular infections. Anton helman is an emergency physician at north york general in toronto. However, according to articles published by experts in the field, the initial approach to diagnosing acute monoarthritis should involve the completion of both a history and a physical examination. It may be a large weightbearing joint, or a smaller joint such as an interphalangeal joint, the great toe metatarsalphalangeal joint, or an elbow. Approach to monoarticular arthritis clinical pearls.
Reactive arthritis including the initial presentation. In gout, the acute inflammatory arthritis is caused by excess uric acid caused by either overproduction or underexcretion. James talks to associate professor neil mcgill about the management of acute monoarthritis on the wards. We identified 4 studies that reported on the differential diagnosis of acute arthritis. Monoarthritis refers to the clinical presentation of pain or swelling in a single joint. Monoarticular presentation of rheumatoid arthritis is infrequent and it usually occurs in the hip and knee joints. There are several possible causes of monoarthritis or monoarticular arthritis as it is also called, including infection, nonspecific inflammatory conditions, crystal deposition, trauma, neoplasm, and immunologic conditions. Acute monoarthritis with associate professor neil mcgill, consultant rheumatologist at royal prince alfred hospital 1. Scribd is the worlds largest social reading and publishing site. Approach to a child with monoarthritis springerlink. To describe isolated knee monoarthritis as a paraneoplastic syndrome heralding nonsmall cell lung cancer nsclc, and to discuss its clinical characteristics. The first step in diagnosis is to verify that the source of pain is the joint, not the surrounding soft tissues. Because knee monoarthritis is the most common presentation of. Patients presenting with a single painful andor inflamed joint require thorough and rapid assessment.
Bursitis and tendinitis can present in a similar manner so it is important to establish that the problem is within the joint. Juvenile idiopathic arthritisadultonset stills disease. Acute monoarthritis is characterised by pain and swelling of a single joint. Started in 1995, this collection now contains 6767 interlinked topic pages divided into a tree of 31 specialty books and 732 chapters. Joel yaphe, university of torontos emergency medicine residency program director and dr. Microsoft word monoarticular arthritis show notes pdf. Monoarthritis definition of monoarthritis by medical. Atypical monoarthritis presentation in children with. Ppt gout powerpoint presentation free to download id. The most common types of arthritis are osteoarthritis and rheumatoid arthritis. The first step in diagno sis is to verify that the source of pain is the joint, not the surrounding soft tissues.
Monoarthritis is relatively unusual so infection and crystalline arthropathies should always be. Almost any joint disorder may begin as monoarthritis, or inflammation of a single joint. Acute monoarthritis describes the acute onset of arthritis affecting a single joint. Management of persistent inflammatory large joint monoarthritis. Patterned approach grouping a constellation of symptoms, signs and investigations to arrive at a diagnosis. We report such a case in a 70yearold male with monoarticular rheumatoid arthritis of the left wrist. Pdf approach to a child with monoarthritis researchgate. The causes of monoarthritis can be classified based on their relative frequencies reported in the literature, despite some variability related to methodological differences. Assessment, investigation, and management of acute. He is an assistant professor at the university of toronto, division of emergency medicine and the education innovation lead at the schwartzreisman emergency medicine instititute. It causes the inflammation of the joints and often starts in the feet or toes. The principal diagnosis to consider is septic arthritis, as a failure rapidly to diagnose this condition can lead to irreversible severe joint damage in a very short time.
Diagnosing acute monoarthritis in adults gout arthritis. Oct 30, 2012 persistent inflammatory monoarthritis is inflammation of one joint, with symptoms lasting beyond 3 months. Monoarthritis definition of monoarthritis by medical dictionary. The current episode began about 1 week prior to presentation and. Rea most often affects adults between 18 and 40 years of age and presents as a monoarthritis or oligoarthritis. Monoarthritis is defined as arthritis involving one joint at a time.
Monoarthritis, defined as inflammation of a single joint, requires a thorough physical examination in children, as pain may be lacking in 10% to 30% of cases and joint stiffness may be the only symptom. The knee, ankle, or one of the metatarsophalangeal joints is usually affected first. Assessment,investigation, andmanagementof acutemonoarthritis simonhtill, mlsnaith the theme of this series is the managementof everydayclinicalproblems thatpresent to accident and emergency departments. Acute monoarthritis can be the initial manifestation of many joint disorders. Before the age of menopause, women have a lower incidence than males, but the rates are equal above this age. Jan, 2017 almost half of jia patients are diagnosed with oligoarticular juvenile idiopathic arthritis oligojia. Review the 2014 idsa guidelines for management of mild, nonpurulent. Ppt approach to monoarthritis powerpoint presentation. What is your general approach to a patient with acute monoarthritis. Almost half of jia patients are diagnosed with oligoarticular juvenile idiopathic arthritis oligojia. Diagnosis of patients presenting with monoarthritis. Monoarthritidies have a relatively short differential diagnosis, including. One of the most common causes of acute monoarthritis is gout. Assessment, investigation, and management of acute monoarthritis.
Where there is any question of this diagnosis, immediate inpatient assessment and management are the safest course 1, 2. The pattern, presentation and duration of arthritis help differentiate between the various possible diagnoses. This is a basic article for medical students and other nonradiologists. Gout can cause mono or polyarthritis, but usually results in. Common causes of monoarthritis are infection, trauma and crystalinduced synovitis. Nov 21, 2016 gonococcal arthritis is the most common type of nontraumatic monoarthritis in young, sexuallyactive young adults. He is the founder, editorinchief and host of emergency medicine cases.
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