Monoarthritis
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Monoarthritis, or monoarticular arthritis, is
inflammation Inflammation (from la, inflammatio) is part of the complex biological response of body tissues to harmful stimuli, such as pathogens, damaged cells, or irritants, and is a protective response involving immune cells, blood vessels, and molec ...
('' arthritis'') of one
joint A joint or articulation (or articular surface) is the connection made between bones, ossicles, or other hard structures in the body which link an animal's skeletal system into a functional whole.Saladin, Ken. Anatomy & Physiology. 7th ed. McGraw- ...
at a time (as opposed to
oligoarthritis Oligoarthritis (from Greek ''oligos'' - 'few') is defined as arthritis Arthritis is a term often used to mean any disorder that affects joints. Symptoms generally include joint pain and stiffness. Other symptoms may include redness, warmth ...
, which affects 2-4 joints, and
polyarthritis Polyarthritis is any type of arthritis that involves 5 or more joints simultaneously. It is usually associated with autoimmune conditions and may be experienced at any age and is not sex specific. Causes Polyarthritis is most often caused by an au ...
, which affects more than 4 joints). It is usually caused by trauma, infection, or crystalline arthritis.


Causes


Septic arthritis

Septic arthritis Acute septic arthritis, infectious arthritis, suppurative arthritis, osteomyelitis, or joint infection is the invasion of a joint by an infectious agent resulting in joint inflammation. Generally speaking, symptoms typically include redness, h ...
is an inflammatory response to an
infection An infection is the invasion of tissues by pathogens, their multiplication, and the reaction of host tissues to the infectious agent and the toxins they produce. An infectious disease, also known as a transmissible disease or communicable dis ...
(usually bacterial) in the joint. Usually impacting large joints like the hip or the knee, it is a medical emergency with a mortality rate of about 10%. It is treated with oral and intravenous
antibiotics An antibiotic is a type of antimicrobial substance active against bacteria. It is the most important type of antibacterial agent for fighting bacterial infections, and antibiotic medications are widely used in the treatment and prevention o ...
as well as joint drainage.


Gout

Gout Gout ( ) is a form of inflammatory arthritis characterized by recurrent attacks of a red, tender, hot and swollen joint, caused by deposition of monosodium urate monohydrate crystals. Pain typically comes on rapidly, reaching maximal intens ...
is inflammation caused by the deposition of needle-shaped
monosodium urate Monosodium glutamate (MSG), also known as sodium glutamate, is the sodium salt of glutamic acid. MSG is found naturally in some foods including tomatoes and cheese in this glutamic acid form. MSG is used in cooking as a flavor enhancer with ...
crystals in the joints. It is the most common type of inflammatory arthritis in the United States. The disease typically affects a single joint in earlier stages but can progress into polyarthritis over time. It usually occurs in cooler areas of the body, often starting in the big toe.


Pseudogout

Pseudogout (also referred to as
calcium pyrophosphate dihydrate crystal deposition disease Calcium pyrophosphate dihydrate (CPPD) crystal deposition disease, also known as pseudogout and pyrophosphate arthropathy, is a rheumatologic disease which is thought to be secondary to abnormal accumulation of calcium pyrophosphate dihydrate crys ...
) is another type of crystalline arthritis that presents very similarly to gout but is caused by the deposition of rhomboid-shaped calcium pyrophosphate dihydrate (CPPD) crystals. The knees, wrists, and fingers are the most common joints affected by pseudogout.


Osteoarthritis

Osteoarthritis is a degenerative, or non-inflammatory arthritis. It is the most common type of arthritis, affecting between 19% and 30% of adults above the age of 45. It is caused by a progressive erosion of cartilage which eventually leads to bone damage. It is a polyarthritis, but it usually begins in a single joint. Unlike other types of monoarthritis, which normally have acute onset, onset of osteoarthritis is almost always insidious.


Psoriatic arthritis

Psoriatic arthritis Psoriatic arthritis is a long-term inflammatory arthritis that occurs in people affected by the autoimmune disease psoriasis. The classic feature of psoriatic arthritis is swelling of entire fingers and toes with a sausage-like appearance. Th ...
is an inflammatory arthritis common in people with
psoriasis Psoriasis is a long-lasting, noncontagious autoimmune disease characterized by raised areas of abnormal skin. These areas are red, pink, or purple, dry, itchy, and scaly. Psoriasis varies in severity from small, localized patches to complete ...
. It often presents as asymmetric oligoarthritis (impacting 2-4 joints) affecting the distal interphalangeal joints, although it can appear in a single joint. Joint-area discoloration,
dactylitis Dactylitis or sausage digit is inflammation of an entire digit (a finger or toe), and can be painful. The word dactyl comes from the Greek word "daktylos" meaning "finger". In its medical term, it refers to both the fingers and the toes. Associa ...
, nail changes, and enthesitis, are common symptoms of psoriatic arthritis that distinguish it from other forms of arthritis. Unlike other types of inflammatory arthritis, which typically affect women more than men, psoriatic arthritis has no gender preference.


Diagnosis

X-rays An X-ray, or, much less commonly, X-radiation, is a penetrating form of high-energy electromagnetic radiation. Most X-rays have a wavelength ranging from 10  picometers to 10 nanometers, corresponding to frequencies in the range 30&nbs ...
,
MRI Magnetic resonance imaging (MRI) is a medical imaging technique used in radiology to form pictures of the anatomy and the physiological processes of the body. MRI scanners use strong magnetic fields, magnetic field gradients, and radio waves ...
scans, and other types of imaging can show bone loss and erosion from degenerative arthritis or later stages of inflammatory arthritis. Laboratory testing, specifically microscopic synovial fluid examination, is a more accurate method of diagnosing arthritis. By performing a
joint aspiration Arthrocentesis, or joint aspiration, is the clinical procedure performed to diagnose and, in some cases, treat musculoskeletal conditions. The procedure entails using a syringe to collect synovial fluid from or inject medication into the joint cap ...
, physicians can check cell counts and look for signs of infection (bacteria/fungus) or crystal formation to determine which, if any, type of arthritis is present.


Treatment

Monoarthritis is treated the same way as other forms of arthritis. Minimizing pain, preventing disease progression, and improving joint function are the goals of arthritis treatment. Treatment can vary depending on the cause and severity of the condition. Physical therapy,
acupuncture Acupuncture is a form of alternative medicine and a component of traditional Chinese medicine (TCM) in which thin needles are inserted into the body. Acupuncture is a pseudoscience; the theories and practices of TCM are not based on scientif ...
, and anti-inflammatory drugs are commonly used to treat the disease. In more severe cases, intra-articular corticosteroid injections or surgical
joint replacement Replacement arthroplasty (from Greek ''arthron'', joint, limb, articulate, + ''plassein'', to form, mould, forge, feign, make an image of), or joint replacement surgery, is a procedure of orthopedic surgery in which an arthritic or dysfunctional ...
may be necessary. Joint drainage and antibiotics are used to treat septic arthritis. Medications that decrease uric acid can mitigate chronic gout symptoms.


See also

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Gout Gout ( ) is a form of inflammatory arthritis characterized by recurrent attacks of a red, tender, hot and swollen joint, caused by deposition of monosodium urate monohydrate crystals. Pain typically comes on rapidly, reaching maximal intens ...
*
Pseudogout Calcium pyrophosphate dihydrate (CPPD) crystal deposition disease, also known as pseudogout and pyrophosphate arthropathy, is a rheumatologic disease which is thought to be secondary to abnormal accumulation of calcium pyrophosphate dihydrate crys ...
*
Septic arthritis Acute septic arthritis, infectious arthritis, suppurative arthritis, osteomyelitis, or joint infection is the invasion of a joint by an infectious agent resulting in joint inflammation. Generally speaking, symptoms typically include redness, h ...
*
Osteoarthritis Osteoarthritis (OA) is a type of degenerative joint disease that results from breakdown of joint cartilage and underlying bone which affects 1 in 7 adults in the United States. It is believed to be the fourth leading cause of disability in the w ...


References


External links

{{Diseases of the musculoskeletal system and connective tissue Arthritis