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Published in Ken Addley, MCQs, MEQs and OSPEs in Occupational Medicine, 2023
Best fit. Lyme disease is the only tick-borne disease in this list. It takes its name from Lyme, Connecticut, USA. It is an occupational zoonosis (i.e., an infectious disease transmitted from animals to humans and contracted in the course of employment). It is caused by bacterium Borrelia burgdorferri which is transmitted by the tick Ixodes ricinus. It is characterised by erythema chronicum migrans—an area of redness spreading out from the site of the bite. The tick is usually associated with deer. Neurological symptoms such as facial nerve neuritis, myelitis, encephalitis and meningitis may all occur as may a myocarditis. Chronic polyarthritis may also be found. Risk of contracting Lyme disease can be reduced by covering skin when outdoors, using insect repellent, inspecting clothes and body for ticks and having good personal hygiene.
Septic Arthritis
Published in Firza Alexander Gronthoud, Practical Clinical Microbiology and Infectious Diseases, 2020
This group is the most common cause of an acutely hot swollen joint in adults and includes: Crystal arthropathy (gout and pseudogout) may mimic septic arthritis in presentation. Clues suggesting crystal arthritis include involvement of the first metatarsophalangeal joint, prior similar attacks and the presence of tophi. Diagnosis is confirmed by seeing crystals in the synovial fluid; however, the presence of crystals doesn't rule out a concomitant septic arthritis.Reactive arthritis secondary to an infection elsewhere in the body, such as urogenital (Chlamydia spp.) or gastrointestinal (e.g.. Campylobacter spp., Yersinia spp.). It may occur in the presence of recent conjunctivitis, mucus membrane lesions and urogenital or gastrointestinal symptoms.Rheumatoid arthritis is more often a symmetrical polyarthritis, but exacerbation of disease in a single joint can occur. The fact that patients with rheumatoid arthritis are at increased risk of developing septic arthritis makes the differentiation all the more difficult.
Rheumatology
Published in Paul Bentley, Ben Lovell, Memorizing Medicine, 2019
Polyarthritis: Virus (rubella = rheumatoid-pattern in hands that lasts months)Lyme
AL amyloidosis presenting as inflammatory polyarthritis: a case report
Published in Modern Rheumatology Case Reports, 2021
Muhammad Shoaib Momen Majumder, Shamim Ahmed, Md. Nahiduzzamane Shazzad, Mohammad Mamun Khan, Syed Atiqul Haq, Mohammed Kamal, Md. Sohrab Alam, Johannes J. Rasker
Polyarthritis encompasses a wide range of differential diagnoses. Rheumatoid arthritis and spondyloarthritis (e.g. reactive arthritis, psoriatic arthritis) are the most common forms of inflammatory polyarthritis. But, there are other systemic autoimmune diseases (e.g. systemic lupus erythematosus, primary Sjogren syndrome, vasculitis, etc.) that may cause joint pain. Diagnosing polyarthritis depends upon an appropriate medical history, a thorough physical examination, and judiciously selected laboratory investigations. There are some rare systemic disorders like amyloidosis, lymphoma, multiple myeloma, POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, myeloma protein, and skin change) that may present with inflammatory arthritis [1]. Amyloidosis is a rare localised as well as systemic disorder that results from the extracellular deposition of a variety of fibrillar proteins leading to changes in tissue architecture or function.
A goal management intervention for patients with polyarthritis and elevated levels of depressive symptoms: a quasiexperimental study
Published in Disability and Rehabilitation, 2020
Roos Y. Arends, Christina Bode, Erik Taal, Mart A. F. J. Van de Laar
In the present study, the effect of a health promotion intervention that focused on coping with threatened activities and life goals due to arthritis was evaluated. Characterized by systemic inflammation, swelling, chronic pain, fatigue, and disability, polyarthritis is a collective term for a variety of chronic conditions associated with autoimmune pathologies. The intervention, called Right on Target, aimed at helping people with polyarthritis and elevated levels of depressive symptoms to increase their goal management competencies and thereby increase their adaptation. Depression and anxiety are components of psychological distress that affect 20 to 40% of the patients [6–12]. Symptoms of depression were chosen as a primary outcome since it is the most studied outcome in relationship to goal management in chronic diseases [13–16] and particularly well-researched and documented among patients with arthritis [8,17–19].
Mangosteen ethanol extract alleviated the severity of collagen-induced arthritis in rats and produced synergistic effects with methotrexate
Published in Pharmaceutical Biology, 2018
Jian Zuo, Qin Yin, Lin Wang, Wen Zhang, Yan Fan, Yu-Yan Zhou, Yan Li, Guo-Dong Wang
Similarly to MG, MAN was efficacious against inflammation especially at the early stage, indicated by the decreases of both arthritis score and paw volume. However, the efficacy was not maintained as CIA progressed. As a first-line DMARD, MTX performed well. The arthritis score of MTX-treated rats was significantly lower than the models throughout the observation period, as was the alleviation of paw swelling. The efficacy of MTX on CIA was further improved by the combination with MAN. The combination treatment suppressed the onset and progression of polyarthritis with the highest efficacy (Figure 1(A)). Compared with monotherapies, the combination therapy of MAN and MTX further reduced the local inflammation indicated by paw volume changes (Figure 1(B)). These results support the synergistic effects of MAN and MTX.