Infectious versus non-infectious causes of oligoarticular inflammatory arthritis: A prospective study from a tertiary care hospital in north India.

Oligoarticular arthritis (inflammation of upto 4 joints) has a wide range of infectious and non-infectious etiologies. The aim of our study was to identify the features which could help in the differentiation of infectious from non-infectious arthritis. The study was prospective and observational, and included 100 patients with oligoarticular inflammatory arthritis. The final diagnosis was made using standard diagnostic criteria and the patients were categorized into infectious and non-infectious groups. Among the 100 patients who were recruited, the following final diagnosis were made: peripheral spondyloarthritis (n = 37), axial spondyloarthritis (n = 11), tuberculosis (n = 19), brucellosis (n = 6), septic arthritis (n = 6), gouty arthritis (n = 5), early rheumatoid arthritis (n = 5), non-tubercular mycobacteria (n = 2), SLE (n = 2), post-chikungunya arthritis (n = 2), acute lymphocytic leukaemia (n = 1), pachydermoperiostosis (n = 1), sarcoidosis (n = 1) and juvenile idiopathoic arthritis (n = 1). The patients were categorized into two groups: infectious (33) and non-infectious (60). The presence of monoarthritis, clinically-significant weight loss, hepatomegaly, splenomegaly and erosive arthritis were significantly more common in the infectious group as compared to the non-infectious group.

[1]  D. Poddubnyy,et al.  Ankylosing spondylitis and axial spondyloarthritis: recent insights and impact of new classification criteria , 2018, Therapeutic advances in musculoskeletal disease.

[2]  P. Ghosh,et al.  Sensitivity and specificity of ultrasonographic features of gout in intercritical and chronic phase , 2017, International journal of rheumatic diseases.

[3]  A. Malaviya,et al.  Clinical characteristics of peripheral spondyloarthritis without psoriasis, inflammatory enteropathy or preceding infection, from a single rheumatology clinic in northern India , 2017, Clinical Rheumatology.

[4]  J. Carter,et al.  Recent advances and future directions in understanding and treating Chlamydia-induced reactive arthritis , 2017, Expert review of clinical immunology.

[5]  S. Dogra,et al.  A case series and review of Poncet's disease, and the utility of current diagnostic criteria , 2016, International journal of rheumatic diseases.

[6]  Praveen Kumar,et al.  Diagnosis of Chlamydia trachomatis in patients with reactive arthritis and undifferentiated spondyloarthropathy. , 2014, Journal of infection in developing countries.

[7]  Cong Yu,et al.  Diagnostic criteria for systemic lupus erythematosus: a critical review. , 2014, Journal of autoimmunity.

[8]  R. Burgos-Vargas The assessment of the spondyloarthritis international society concept and criteria for the classification of axial spondyloarthritis and peripheral spondyloarthritis: A critical appraisal for the pediatric rheumatologist , 2012, Pediatric Rheumatology.

[9]  B. Mete,et al.  Musculoskeletal Hydatid Disease , 2011, Seminars in musculoskeletal radiology.

[10]  A. Silman,et al.  Rheumatoid arthritis classifi cation criteria : an American College of Rheumatology / European League Against Rheumatism collaborative initiative , 2010 .

[11]  C. van Weel,et al.  A diagnostic rule for acute gouty arthritis in primary care without joint fluid analysis. , 2010, Archives of internal medicine.

[12]  A. Malaviya,et al.  Clinical characteristics of patients with ankylosing spondylitis in India , 2009, Clinical Rheumatology.

[13]  C. Muangchan,et al.  The study of clinical manifestation of osteoarticular tuberculosis in Siriraj Hospital, Thailand. , 2009, Journal of the Medical Association of Thailand = Chotmaihet thangphaet.

[14]  A. Malaviya,et al.  Diagnosis delay in patients with ankylosing spondylitis: factors and outcomes—an Indian perspective , 2009, Clinical Rheumatology.

[15]  B. Mantur,et al.  Brucellosis in India — a review , 2008, Journal of Biosciences.

[16]  S. Splain,et al.  Multifocal osteoarticular tuberculosis. , 2005, Orthopedics.

[17]  Y. Song,et al.  Clinical manifestations and diagnosis of extrapulmonary tuberculosis. , 2004, Yonsei medical journal.

[18]  Karina D. Torralba,et al.  Sarcoid arthritis: a review of clinical features, pathology and therapy. , 2003, Sarcoidosis, vasculitis, and diffuse lung diseases : official journal of WASOG.

[19]  D. Goldenberg,et al.  Septic arthritis , 1998, The Lancet.

[20]  T. Kvien,et al.  Prediction of diagnosis in acute and subacute oligoarthritis of unknown origin. , 1996, British journal of rheumatology.

[21]  N. Mehra,et al.  HLA B27 related 'unclassifiable' seronegative spondyloarthropathies. , 1983, Annals of the rheumatic diseases.

[22]  B. Mete,et al.  Musculoskeletal brucellosis. , 2011, Seminars in musculoskeletal radiology.