Approach to monoarthritis

Approach to patient with monoarthritis : 

Monoarthritis : কয় ধরনের?

• Acute
• Chronic 

1.Acute monoarthritis :  Acute আবার কি কি হতে পারে? 

• Septic 
• Gout 
• Pseudogout 
• Trauma 
• Reactive arthritis 
• Hemarthrosis-Trauma, coagulation disorder Monozarticular presentation of oligoarthritis 

2.Chronic monoarthritis :Chronic হলে কি কি হতে পারে 

• OA 
  
• TB arthritis
• Hemophilic arthritis 
• Monoarticular presentation of oligoarthritis 

Septic arthritis : কি কি থাকবে 

1)Large limb joints. eg-knee is the most common immunocompromized(DM, Drugs, HIV), Elderly(>80), prosthetic joints, skin infection recent joint surgery, IV drug abuser, IA injection, ESRD, advanced hepatic disease, sickle  cell disease, underlying malignancy, hypogammaglobinaemia, hemophillia 

2)Fever :Onset of pain over days to weeks 

3)Erythematous, hot teder joints, loose pack position 

Septic arthritis 

1)Raised ESR, CRP 

2)CSF Study : 

• Cloudy, TC>50,000, Neutrophilic -gm stain & C/S may be +ve 
• Staph aureus is the most common organism,