1. Congenital Causes
– Achondroplasia: Premature osteoarthritis may occur in achondroplasia.
– Ehlers-Danlos syndrome: a genetic disorder of connective tissues in which patients have hypermobile joints and hyperextensible skin. they may present with joint subluxation, dislocations and swelling due to effusions.
– Marfan Syndrome: Patients have generalized joint laxityand present with joint pain and swelling due to effusions.
– Osteogenesis Imperfecta: Patients have brittle bones that lead to easy joint dislocations.
2. Accquired Causes
- Septic or pyogenic arthritis usually present as a monoarthritis with a red , swollen, painful, immobile joint. Usually a single joint is involved.
- Viral arthritis may occur following viral illness like rubella, mumps, hepatitis etc.
- In rheumatic fever which usually follows a streptococcal infection. There is a migratory poly arthritis together with carditis, erythematous skin lesions and sub cutaneous nodules.
- Rheumatoid arthritis presents initially with swollen, painful, stiff hands and feet. Later characteristic deformities develop. Most commonly swelling is seen at metacarpophalangeal joints.
- Psoriatic arthropathy usually follows several years after skin lesions.
- Reiter’s disease may present with arthritis in a single or few joints. There will be a history of sexual contact, urethritis and conjunctivitis.
- Ankylosing spondylitis presents in young males and initially presents with morning stiffness in the spine. The sacroilliac joints are involved. Continue reading “Differential Diagnosis Of Joint Disorders”