Polyarthritis (also known as polyarthritis or inflammatory polyarthritis) is defined as arthritis or joint pain that affects five or more joints at the same time.
The term itself simply describes the number of joints involved – poly means a lot. Therefore, it can be used to describe any number of conditions, permanent or transient, in which more than five joints are affected.
Polyarthritis is most commonly associated with autoimmune diseases such as rheumatoid arthritis (RA), but it can also be caused by certain viral infections.
The symptoms of polyarthritis are often similar to those of rheumatoid arthritis and other autoimmune diseases. They can develop suddenly or over many months.
Signs of joint inflammation are often dramatic in nature, such as swelling, warmth, pain, and decreased range of motion. Morning stiffness and pain, which improve with physical activity and worsen with rest, are classic manifestations of inflammatory arthritis.
Other symptoms include :
- Lack of appetite
- Swollen lymph nodes
- Temperature 100.4 degrees and above
- Fatigue or lack of energy
- Unexpected weight loss
Polyarthritis is most commonly caused by an autoimmune disease in which a person's immune system mistakenly attacks its own cells and tissues. The causes of autoimmune diseases are not fully understood, but are believed to be closely related to genetics and the environment.
Because autoimmune diseases tend to trigger a whole-body response (these are systemic diseases with many symptoms), polyarticular joint involvement does not generally appear in isolation, as in osteoarthritis . Rather, there are many other major symptoms (like a rash).
The autoimmune diseases most commonly associated with polyarthritis include:
Polyarthritis can also occur as part of an acute illness such as rheumatic fever , as well as certain alphavirus infections , such as the Ross River virus, Chikungunya virus, and Mayaro virus . Dengue, Zika, hepatitis, EBV, and CMV can also cause polyarthritis. In these cases, the inflammation can be temporary and travel between multiple joints.
When polyarthritis occurs in children, it is called juvenile idiopathic arthritis or JIA; the reason is unknown.
Since polyarthritis is most commonly associated with autoimmune diseases, your healthcare provider usually begins by trying to determine the underlying cause of your joint pain. Swollen joints, pain, joint effusion (known as water on the knees), and swelling are common signs of autoimmune diseases.
Your healthcare provider will determine if your pain is symmetrical (for example, symptoms occur in both arms or knees) or asymmetric. (only the joints on one side are symptomatic). People with RA tend to experience symmetrical symptoms, while psoriatic arthritis patients often experience asymmetric symptoms.
Your healthcare provider can also look for anemia, elevated white blood cell counts, elevated platelets, and elevated inflammatory markers known as erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP).
Serological tests can also be helpful in looking for specific antibodies associated with the autoimmune disease in question.
X- rays , musculoskeletal ultrasound, magnetic resonance imaging (MRI), and / or joint fluid analysis (also known as arthrocentesis ) may be ordered depending on the suspected cause. Your healthcare professional will also test you for viruses if an infectious cause is suspected.
Treatment for polyarthritis is usually the same as for autoimmune diseases. They include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) : Advil (ibuprofen), Alev (naproxen), and Voltaren (diclofenac) can help relieve pain and stiffness.
- Disease-modifying antirheumatic drugs (DMARDs) : help slow the progression of autoimmune diseases. Methotrexate is often prescribed to reduce joint damage caused by arthritis.
- Biologics : These drugs, including Remicade (infliximab) and Embrel (etanercept), modify the immune system to reduce inflammation.
- Corticosteroids : help control inflammation and reduce pain. Steroids can be taken orally or by injection. They should only be used short-term as they can cause serious side effects.
- Warming therapy : Warm baths, warming gloves, and over-the-counter topical creams like Aspercreme may temporarily relieve symptoms.
- Exercise : Low intensity exercise, such as swimming, yoga, and stretching , can help keep your joints healthy.
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It is important to treat your arthritis before the condition worsens and permanently damages your joints. In rare cases, polyarthritis can cause scarring of the lungs, dry eyes, skin rashes, and pericarditis (inflammation in the sac that surrounds the heart). If you experience pain in five or more joints, you should see your doctor.