関: monarthritis

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/09/26 21:38:44」(JST)

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Monoarthritis is inflammation (arthritis) of one joint at a time. It is usually caused by trauma, infection, or crystalline arthritis.

1 Diagnosis
2 Causes
- 2.1 Septic arthritis
- 2.2 Gout
- 2.3 Pseudogout
- 2.4 Osteoarthritis
- 2.5 Monoarthritic form of Chronic Juvenile Arthritis (CJA)
- 2.6 Seronegative Spondyloarthropathy
- 2.7 Traumatic arthritis
- 2.8 Psoriatic arthritis
- 2.9 Haemarthrosis
- 2.10 Hemophila
- 2.11 Monoarticular presentation of polyarticular disease
3 See also

Diagnosis[edit]

When faced with monoarthritis, one of the main decisions to make is whether to perform a joint aspirate by inserting a needle into the affected joint and removing some fluid for microscopic analysis. This decision is largely taken on inflammatory markers in blood tests (e.g. CRP), fever and the clinical picture. The main use of aspiration is to detect bacteria and neutrophil granulocytes (in septic arthritis) and crystals (crystal arthropathies).

Causes[edit]

Septic arthritis[edit]

Septic arthritis is due to a bacterial infection to the joint. It requires urgent joint washout in the operating room followed by intravenous antibiotic therapy for large joints. Small joints or children can be treated with repeated aspirations and intravenous antibiotics.

Gout[edit]

In gout, the acute inflammatory arthritis is caused by excess uric acid caused by either overproduction or under-excretion. Before the age of menopause, women have a lower incidence than males, but the rates are equal above this age. Gout can cause mono- or polyarthritis, but usually results in monoarthritis first.

Pseudogout[edit]

When monoarthritis is caused by pseudogout (calcium pyrophosphate deposition disease, CPPD), the inflammation usually lasts days to weeks, and involves the knees in half of all attacks. Like gout, attacks can occur spontaneously or with physical trauma or metabolic stress. Patients may feel well in between pseudogout attacks, and 5% present with pseudo-rheumatoid symptoms.

Osteoarthritis[edit]

Osteoarthritis is a degenerative disease commonly involving the knees and hips. It results from erosion of the cartillage protecting the bones from rubbing together. Osteoarthritis is, in fact, a polyarthritis but it starts initially in one joint before the involvement of other joints. Hence, mimicking monoarthritis.

Monoarthritic form of Chronic Juvenile Arthritis (CJA)[edit]

Seronegative Spondyloarthropathy[edit]

Traumatic arthritis[edit]

Psoriatic arthritis[edit]

Haemarthrosis[edit]

Hemophila[edit]

Monoarticular presentation of polyarticular disease[edit]

UpToDate Contents

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1. 成人における単関節痛の評価 evaluation of the adult with monoarticular pain
2. 関節の疼痛または腫脹を有する小児の評価 evaluation of the child with joint pain or swelling
3. 成人における敗血症性関節炎 septic arthritis in adults
4. 関節リウマチの臨床症状 clinical manifestations of rheumatoid arthritis
5. 痛風の臨床症状および診断 clinical manifestations and diagnosis of gout

English Journal

Role of scintigraphy with (99m)Tc-infliximab in predicting the response of intraarticular infliximab treatment in patients with refractory monoarthritis.

Conti F, Malviya G, Ceccarelli F, Priori R, Iagnocco A, Valesini G, Signore A.SourceRheumatology Unit, Faculty of Medicine and Dentistry, "Sapienza" University of Rome, Rome, Italy.
European journal of nuclear medicine and molecular imaging.Eur J Nucl Med Mol Imaging.2012 Aug;39(8):1339-47. Epub 2012 May 16.
PURPOSE: The rationale for the present study was to evaluate the predictive role of (99m)Tc-infliximab scintigraphy in therapy decision-making in patients with refractory monoarthritis and also candidates for intraarticular (IA) infliximab treatment.METHODS: We studied 12 patients (5 with rheumatoid
PMID 22588625

Methotrexate is an option for patients with refractory calcium pyrophosphate crystal arthritis.

Andres M, Sivera F, Pascual E.SourceFrom the *Sección de Reumatología, Hospital General Universitario de Alicante; †Sección de Reumatología, Hospital General de Elda; and ‡Universidad Miguel Hernández de Elche, Alicante, Spain.
Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases.J Clin Rheumatol.2012 Aug;18(5):234-6.
BACKGROUND: Patients with calcium pyrophosphate deposition disease sometimes require a continuous therapy. Nonsteroidal anti-inflammatory drugs, colchicine, and glucocorticoids are commonly used with good results, but occasionally, these are ineffective, contraindicated, or not tolerated. We present
PMID 22832286

Japanese Journal

Hip monoarthritis in a child with cat-scratch disease : Rare manifestation

KOSSIVA Lydia,VAKAKI Marina,PASPARAKIS Dimitris,KALLERGI Konstantina,KARAVANAKI Kyriaki,GAROUFI Anastasia
Pediatrics international : official journal of the Japan Pediatric Society 52(4), 680-681, 2010-08-01
NAID 10028183926