Understanding Polyarthritis

Many things can cause polyarthritis including Structural arthritis, autoimmune disease, crystal arthritis, infectious arthritis, medicine-related arthritis and paraneoplastic syndromes.

• Structural arthritis:
  • Osteoarthritis
  • Trauma
• Autoimmune disease:
  • Rheumatoid arthritis
  • Psoriatic arthritis
  • Sjogrens syndrome
  • Reactive arthritis
  • Myositis
  • Lupus
  • Vasculitis
  • Sarcoid
• Crystal arthritis:
  • Gout
  • Psuedogout
• Infectious arthritis:
  • Bacterial infections
    • Lyme disease
    • Staph infection (staphylococcus)
    • Meningococcal infection
  • Viral infections
    • Hepatitis A, B, or C
    • HIV
    • Rubella
    • Human parovirus B19
    • Epstein-Barr virus
    • Paraneoplastic syndromes
• Medicine side effects most commonly from antithyroid medicines, antibiotics such as clindamycin, and immune checkpoint inhibitors.
• Paraneoplastic syndromes

Symptoms may vary for each person, depending on the cause. They may start suddenly, or occur for a few months. Symptoms can include:

• Joint pain
• Joint swelling
• Warmth and redness in the affected area
• Stiff joints
• Decreased ability to make certain motions

In addition to joint related symptoms, people with certain forms of polyarthritis may also have rashes, sweating unexplained weight loss, fatigue and fever.

Polyarthritis can have many possible causes, so making a diagnosis can be difficult. Your healthcare provider will ask about your health history and do a physical exam. They will check to see which joints are affected. And they will check if the joint pain is on both sides of your body (symmetric pain) or only in joints on one side of the body (asymmetrical pain). They will ask you when your symptoms started, and how severe they have been.

You may also need one or more tests such as:

• Complete blood count (CBC). This is done to look for viral infections.
• Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) tests. These can help to differentiate between inflammatory and noninflammatory conditions.
• Certain blood tests to look for autoimmune disease such as ANA (antinuclear antibody), RF (rheumatoid factor) and CCP (cyclic citrulinated peptide).
• Serum uric acid. High uric acid levels may mean you have gout although some people with high uric acid don't have gout.
• Synovial fluid tests (joint aspiration). A sample of the thick fluid between your joints may be taken and checked in a lab.
• Imaging tests. An X-ray can provide a detailed look at the bones. A CT scan or MRI can help show damage to the whole joint.

The goal of treatment is to reduce inflammation and manage symptoms. Depending on what is causing the polyarthritis, your healthcare provider may advise you to take certain medicines:

• Acetaminophen can provide pain relief.
• Nonsteroidal anti-inflammatory drugs (NSAIDs). These medicines can help ease fever and pain, and reduce any swelling and stiffness. They include over-the-counter medicines such as naproxen and ibuprofen, and prescription medicines.
• Antibiotics. These can help when the cause is an infection.
• Corticosteroids. These can ease pain and control inflammation. They also slow down the immune response. They may be taken by mouth (orally) or as a shot (injection).
• Disease-modifying anti-rheumatic drugs (DMARDs). These medicines help slow down the immune system response for people with certain autoimmune causes of polyarthritis.

In addition, a treatment plan may include:

• Exercise. Low-impact exercise that’s easy on the joints is helpful. This includes swimming, biking, yoga, and walking.
• Heat or cold therapy. This can help to ease pain.
• Using a splint or sling. Preventing an affected joint from moving by using a splint or sling can also help ease pain.