title: Viral arthritis.
abstract: Acute-onset arthritis is a common clinical problem facing both the general clinician and the rheumatologist. A viral aetiology is though to be responsible for approximately 1% of all cases of acute arthritis with a wide range of causal agents recognised. The epidemiology of acute viral arthritis continues to evolve, with some aetiologies, such as rubella, becoming less common due to vaccination, while some vector-borne viruses have become more widespread. A travel history therefore forms an important part of the assessment of patients presenting with an acute arthritis. Worldwide, parvovirus B19, hepatitis B and C, HIV and the alphaviruses are among the most important causes of virally mediated arthritis. Targeted serological testing may be of value in establishing a diagnosis, and clinicians must also be aware that low-titre autoantibodies, such as rheumatoid factor and antinuclear antibody, can occur in the context of acute viral arthritis. A careful consideration of epidemiological, clinical and serological features is therefore required to guide clinicians in making diagnostic and treatment decisions. While most virally mediated arthritides are self-limiting some warrant the initiation of specific antiviral therapy.
authors.affiliation: Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK, and The Hospital for Tropical Diseases, London, UK.
authors.forename: Michael
authors.initials: M
authors.lastname: Marks
authors.affiliation: Department of Rheumatology, Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust, Dorset, UK jonathan.marks@rbch.nhs.uk.
authors.forename: Jonathan L
authors.initials: JL
authors.lastname: Marks
mesh_terms: D001170:Arthritis, Infectious / Q000453:epidemiology / Q000821:virology; D006801:Humans; D014780:Viruses / Q000472:pathogenicity
keywords: Arthritis; alphavirus; arthralgia; hepatitis; parvovirus B19