Oligoarthritis and monoarthritis

The aim of this topic is to review the pathophysiology of the common causes of inflammation affecting one joint (monoarthritis) or several joints (oligoarthritis). In particular, you should become conversant with the clinical features and investigation of common arthritides.

Learning objectives:

At the completion of this topic you should be able to:

1. Draw and label a diagram that shows the main features of a typical synovial joint.
2. Give the differential diagnosis of acute monoarthritis, noting in particular features of the history and examination that may distinguish between diagnoses.
3. Construct a table that shows the features of normal synovial fluid, and the abnormalities that typify degenerative joint disease (DJD), acute gout, pseudogout and suppurative arthritis.
4. Outline the pathogenesis of primary DJD and list the common causes of secondary DJD.
5. Explain the classical radiological appearances of DJD on the basis of changes in joint cartilage and subchondral bone.
6. Outline the pathophysiology of hyperuricaemia and list investigations that might reveal an underlying cause (secondary hyperuricaemia).
7. Explain the pathogenesis of acute gouty arthritis and list the common precipitating factors.
8. Describe the polarising microscopic appearances of crystals in synovial fluid.
9. Describe the complications of untreated chronic hyperuricaemia.
10. Outline the factors that predispose an individual to develop acute suppurative arthritis, and list the common microbial causes.
11. List the causes and clinical features of hypertrophic pulmonary osteoarthropathy (HPOA).

1. Compare and contrast the clinical and synovial fluid abnormalities between acute monoarthritis due to gout and septic arthritis.
2. Write brief notes on the proposed pathogenesis of degenerative joint disease.

Case protocol associated with this topic - 28

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