Monoarticular arthritis

Differential Diagnosis

Monoarticular arthritis

Algorithm for Monoarticular arthralgia

• Acute osteoarthritis
• Avascular necrosis
• Crystal-induced (Gout, Pseudogout)
• Gonococcal arthritis, arthritis-dermatitis syndrome
• Nongonococcal septic arthritis
• Lyme disease
• Malignancy (metastases, osteochondroma, osteoid osteoma)
• Reactive poststreptococcal arthritis
• Trauma-induced arthritis
  • Fracture
  • Ligamentous injury
  • Overuse
• Avascular necrosis
• Decompression sickness
• Spontaneous osteonecrosis
• Hemorrhagic (e.g. hemophilia, systemic anticoagulation
• Seronegative spondyloarthropathies (ankylosing spondylitis, IBD, psoriatic arthritis, reactive arthritis
• RA, SLE
• Sarcoidosis, amyloidosis
• Periarticular pathology
  • Cellulitis
  • Tendonitis
  • Bursitis
• Transient (Toxic) Synovitis (Hip)
• Slipped Capital Femoral Epiphysis (SCFE)
• Legg Calve Perthes Disease

Septic Arthritis

• Gonococcal arthritis
• Nongonococcal Arthritis
• Arthritis-Dermatitis Syndrome

Crystal-Induced Monoarthritis

• Gout
• Pseudogout

Traumatic

• Fracture
• Ligamentous injury
• Overuse

Ischemic

• Avascular necrosis
• Decompression sickness
• Spontaneous osteonecrosis
  • pain in absence of trauma
  • femoral head, medial conyle of knee

Hemorrhagic

• Posttraumatic
• Hemophilia
• Systemic anticoagulation

Neoplastic

• Metastases
• Osteochondroma
• Osteoid osteoma
• Pigmented villonodular synovitis

Systemic Disease

• Remote infection, infectious endocarditis
• Rheumatic fever
• Seronegative (no RF) spondyloarthropathies (ankylosing spondylitis, IBD, psoriatic, reactive arthritis)
• Rheumatoid arthritis, SLE
• Sarcoidosis, amyloidosis

Periarticular (mimic joint involvement)

• Cellulitis
• Tendonitis
• Bursitis

Pediatric

• Transient (Toxic) Synovitis (Hip)
• Slipped Capital Femoral Epiphysis (SCFE)
• Legg Calve Perthes Disease

See Also

• Pseudogout
• Gout
• Septic Arthritis (Hip)
• Septic Arthritis (General)
• Arthritis