The differential diagnosis of subacute-acute monoarthritis includes:
- Septic arthritis (gonococcal, non-gonnococcal bacterial, tuberculosis, fungal)
- Crystal (gout, pseudogout AKA CPPD, hydroxyapatate)
- Osteoarthritis flare
More rarely an acute monoarthritis can be a presentation of
- Seropositive and seronegative arthridities including reactive arthritis and post-streptococcal arthritis
- Hemarthrosis (in hemophilia and acquired hemophilia)
We use the history and physical to help us form an opinion on the etiology, but ultimately because septic arthritis is so damaging if missed, a synovial fluid analysis is required if there is suspicion of septic arthritis.
A previous blog discussed septic arthtiris and synovial fluid analysis.
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