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Explanation
Sequential monoarthritis in several joints is characteristic of gonococcal arthritis or rheumatic fever.
Monoarthritis occasionally is the first presenting symptom of an inflammatory polyarthritis such as psoriatic arthritis but is an unusual initial symptom of rheumatoid arthritis.
When the history reveals longstanding symptoms in a joint, exacerbations of preexisting disease (e.g., worsening of osteoarthritis with excessive use) should be differentiated from a superimposed infection.
In patients with rheumatoid arthritis, pain in one joint out of proportion to pain in other joints always suggests infection.
Sexual history and history of illegal drug use, alcohol use, travel, and tick bites should be ascertained. Reactive arthritis sometimes can develop after a gastrointestinal or sexually transmitted disease.
Certain occupations, such as farming and mining, frequently are associated with overuse injures and osteoarthritis.
Category: Internal Medicine MCQs , Medicine MCQs
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