Polyarthritis

Polyarthritis is a condition defined by inflammation in multiple joints, typically five or more. It can be acute or chronic and results from inflammatory, infectious, crystal-related, or non-inflammatory processes.

Common inflammatory causes include rheumatoid arthritis, psoriatic arthritis, systemic lupus erythematosus, and other seronegative spondyloarthropathies. Infectious polyarthritis may follow gonococcal infection, reactive arthritis, or viral illnesses such as parvovirus B19 or chikungunya. Non-inflammatory forms can include advanced osteoarthritis or mechanically driven joint involvement.

Patients usually experience joint swelling, warmth, pain, and reduced range of motion. Morning stiffness lasting more than 30 minutes is typical of inflammatory disease. The pattern is often symmetric and involves small joints of the hands and feet, but larger joints may be affected.

Diagnosis uses clinical assessment supported by laboratory tests and imaging. Lab work may include complete blood count, erythrocyte sedimentation rate or C-reactive protein, rheumatoid factor, anti-CCP antibodies, ANA, and uric acid. Imaging starts with X-rays and may employ ultrasound or MRI; joint fluid analysis helps exclude infection.

Management aims to treat the underlying cause and relieve symptoms. NSAIDs and acetaminophen provide relief; corticosteroids may be used short term. Disease-modifying antirheumatic drugs such as methotrexate, sulfasalazine, or leflunomide, and biologics targeting specific immune pathways, are central for autoimmune polyarthritis. Physical therapy and lifestyle modifications are important.

Prognosis varies with cause and timeliness of treatment. Among autoimmune polyarthritis, early diagnosis and appropriate therapy improve function and reduce joint damage; infections require prompt antimicrobial therapy. Polyarthritis is more common in adults, particularly women in autoimmune conditions, while infectious polyarthritis is often acute.