Book contents
- Frontmatter
- Dedication
- Contents
- List of Contributors
- Preface
- Part I Clinical syndromes: general
- Part II Clinical syndromes: head and neck
- Part III Clinical syndromes: eye
- Part IV Clinical syndromes: skin and lymph nodes
- Part V Clinical syndromes: respiratory tract
- Part VI Clinical syndromes: heart and blood vessels
- Part VII Clinical syndromes: gastrointestinal tract, liver, and abdomen
- Part VIII Clinical syndromes: genitourinary tract
- Part IX Clinical syndromes: musculoskeletal system
- 68 Infection of native and prosthetic joints
- 69 Bursitis
- 70 Acute and chronic osteomyelitis
- 71 Polyarthritis and fever
- 72 Infectious polymyositis
- 73 Iliopsoas abscess
- Part X Clinical syndromes: neurologic system
- Part XI The susceptible host
- Part XII HIV
- Part XIII Nosocomial infection
- Part XIV Infections related to surgery and trauma
- Part XV Prevention of infection
- Part XVI Travel and recreation
- Part XVII Bioterrorism
- Part XVIII Specific organisms: bacteria
- Part XIX Specific organisms: spirochetes
- Part XX Specific organisms: Mycoplasma and Chlamydia
- Part XXI Specific organisms: Rickettsia, Ehrlichia, and Anaplasma
- Part XXII Specific organisms: fungi
- Part XXIII Specific organisms: viruses
- Part XXIV Specific organisms: parasites
- Part XXV Antimicrobial therapy: general considerations
- Index
- References
71 - Polyarthritis and fever
from Part IX - Clinical syndromes: musculoskeletal system
Published online by Cambridge University Press: 05 April 2015
- Frontmatter
- Dedication
- Contents
- List of Contributors
- Preface
- Part I Clinical syndromes: general
- Part II Clinical syndromes: head and neck
- Part III Clinical syndromes: eye
- Part IV Clinical syndromes: skin and lymph nodes
- Part V Clinical syndromes: respiratory tract
- Part VI Clinical syndromes: heart and blood vessels
- Part VII Clinical syndromes: gastrointestinal tract, liver, and abdomen
- Part VIII Clinical syndromes: genitourinary tract
- Part IX Clinical syndromes: musculoskeletal system
- 68 Infection of native and prosthetic joints
- 69 Bursitis
- 70 Acute and chronic osteomyelitis
- 71 Polyarthritis and fever
- 72 Infectious polymyositis
- 73 Iliopsoas abscess
- Part X Clinical syndromes: neurologic system
- Part XI The susceptible host
- Part XII HIV
- Part XIII Nosocomial infection
- Part XIV Infections related to surgery and trauma
- Part XV Prevention of infection
- Part XVI Travel and recreation
- Part XVII Bioterrorism
- Part XVIII Specific organisms: bacteria
- Part XIX Specific organisms: spirochetes
- Part XX Specific organisms: Mycoplasma and Chlamydia
- Part XXI Specific organisms: Rickettsia, Ehrlichia, and Anaplasma
- Part XXII Specific organisms: fungi
- Part XXIII Specific organisms: viruses
- Part XXIV Specific organisms: parasites
- Part XXV Antimicrobial therapy: general considerations
- Index
- References
Summary
Polyarticular joint pain with fever poses a unique diagnostic challenge given the magnitude of complaint, urgency to identify the underlying cause, and the uncertainty of outcome. Knowledge of the most prevalent causes of polyarthritis associated with fever can facilitate an accurate diagnosis and appropriate therapy. Polyarthritis is defined as inflammatory pain with swelling affecting four or more joints. The distribution, chronology of joint inflammation, and host factors (e.g., demographics, comorbidities, geography) help refine the diagnostic possibilities. The presence of fever is notable as most polyarticular conditions do not manifest substantial or sustained fever. Nevertheless, fever or pyrexia is further evidence of an inflammatory, infectious, or autoimmune disorder. This chapter will examine the diagnostic approach to polyarthritis and pyrexia.
History and physical exam
The diagnosis of any disease relies heavily on the history and physical examination. Eliciting an accurate history will identify those who are at risk for significant morbidity and mortality. The goals of the encounter are to: (1) relieve symptoms, (2) treat the underlying disease, and (3) avoid irreversible organ damage. Characteristics distinguishing arthritis include prolonged morning stiffness, warmth, erythema, tenderness to palpation, swelling, and joint effusion. Range of motion, muscle strength, and function may be limited around the inflamed joint. In an effort to reduce joint volume and pain, the patient may involuntarily hold the joint in a position of partial flexion. Hence, joint contracture may be evidence of an inflammatory process. The key elements that should be obtained from history and physical exam are as follows and simplified in Figure 71.1.
- Type
- Chapter
- Information
- Clinical Infectious Disease , pp. 454 - 459Publisher: Cambridge University PressPrint publication year: 2015