section name header

Table 28.2

Focused Assessment of Acute Arthritis

History
  • Duration and time course of arthritis and other symptoms (e.g. fever, rash, diarrhoea, urethritis, uveitis).
  • Known arthritis or prosthetic joint?
  • Previous similar attacks of arthritis?
  • History of trauma?
  • Possible septic arthritis? Septic arthritis usually follows a bacteraemia (e.g. from IV drug use) in a patient at risk because of rheumatoid arthritis, the presence of a prosthetic joint or immunocompromise.
  • Risk of gonococcal arthritis?
  • Other illness?
  • Current medication
Examination
  • Key observations plus systematic examination.
  • Pattern of joint involvement: monoarthritis, oligoarthritis (two to four joints) or polyarthritis (five joints or more) (see Table 28.1).
  • Arthritis or periarticular inflammation (bursitis, tendinitis or cellulitis)? Painful limitation of movement of the joint suggests arthritis.
  • Extra-articular signs (e.g. fever, rash, mouth ulcers, anterior uveitis, urethritis).