Approach to a child with monoarthritis.
Arthritis in childhood is common. The pattern, presentation and duration of arthritis help differentiate between the various possible diagnoses. When only one joint is involved, i.e., monoarthritis, it may be difficult to make a diagnosis as there are many possibilities both acute and chronic in nature. A detailed history and clinical examination is important to reach a correct diagnosis and the single most important investigation when a child presents acutely is a joint aspiration to rule out septic arthritis that may destroy the joint in hours. Inflammatory markers, antinuclear antibody testing, test for tuberculosis and imaging (in specific cases) play an important role in the diagnosis of a child that presents with a chronic monoarthritis. In this article we provide a clinical approach to the diagnosis of monoarthritis in a child.
Prabhu
A S
AS
Department of Pediatrics, Amrita Institute of Medical Sciences, Amrita Institute of Health Sciences, P.O Elamakkara, Kochi, India.
Balan
Suma
S
D000208:Acute Disease; D000293:Adolescent; D001170:Arthritis, Infectious / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D001172:Arthritis, Rheumatoid / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D001175:Arthrography; D001774:Blood Chemical Analysis; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007194:India; D008297:Male; D010147:Pain Measurement; D010808:Physical Examination; D013582:Synovial Fluid / Q000166:cytology; D014057:Tomography, X-Ray Computed / Q000379:methods
Postgrad Med. 1980 Sep;68(3):175-9, 182-4
6159617
J Am Acad Orthop Surg. 2009 Oct;17(10):618-26
19794219
J Rheumatol. 2001 Jan;28(1):204-6
11196526
Arch Dis Child. 2000 Oct;83(4):342-6
10999874
Indian J Pediatr. 2008 Nov;75(11):1188
18810350
J Trop Pediatr. 2005 Aug;51(4):250-1
15927950
Infect Dis Clin North Am. 2005 Dec;19(4):853-61
16297736
J Pediatr. 1999 Jan;134(1):53-7
9880449
Ann Rheum Dis. 2005 Mar;64(3):491-3
15708901
Arthritis Rheum. 1998 Jul;41(7):1210-4
9663477
J Bone Joint Surg Am. 1999 Dec;81(12):1662-70
10608376
Radiol Clin North Am. 2004 Jan;42(1):135-49
15049528
Lancet. 1973 Jul 21;2(7821):157
4124084
J Pediatr Surg. 1993 Dec;28(12):1597-600
8301505
Arch Dis Child. 2001 Sep;85(3):223-7
11517105
Postgrad Med. 1996 Apr;99(4):127-31, 135-9
8604401
HSS J. 2010 Feb;6(1):37-42
19921342
Pediatr Rheumatol Online J. 2008 Sep 18;6:15
18799014
Arthritis Rheum. 1999 Nov;42(11):2330-4
10555028
Arch Dis Child. 2005 Jan;90(1):69
15613517
Iowa Orthop J. 2007;27:90-4
17907437