Management of Acute Arthritis
| Cause of acute arthritis | Management |
|---|---|
| Septic arthritis | Antibiotic therapy (Table 28.4) |
| See Chapter 98 | Joint drainage |
| Seek advice from orthopedic surgeon/rheumatologist | |
| Gout | High-dose NSAID (consider PPI cover) |
| See Chapter 97 | Colchicine if NSAID contraindicated Oral corticosteroid (prednisolone 40 mg daily for 1–2 days, then tapered over 7–10 days) if NSAID/colchicine contraindicated or not tolerated |
| Consider intra-articular corticosteroid in place or oral corticosteroid if only one joint affected | |
| Pseudogout | Joint drainage |
| See Chapter 97 | Intra-articular corticosteroid |
| NSAID (consider PPI cover) | |
| Colchicine if NSAID contraindicated | |
| Flare of rheumatoid arthritis | Seek advice from rheumatologist |
| Flare of osteoarthritis | NSAID (consider PPI cover) |
| Intra-articular corticosteroid |
NSAID, non-steroidal anti-inflammatory drug; PPI, proton pump inhibitor.