Prediction of Diagnosis in Acute and Subacute Oligoarthritis of Unknown Origin

Abstract

A total of 146 consecutive patients between 18 and 60 yr of age with oligoarthritis of unknown origin (< or = 6 active joints, < or = 8 weeks duration) were examined by a variety of clinical, laboratory and microbiological investigations, and followed longitudinally for 24 weeks. Reactive arthritis was diagnosed in 46 patients (19 induced by Chlamydia trachomatis, 27 by enterobacteria), 62 had undifferentiated arthritis, eight other inflammatory arthritic diseases, 15 acute sarcoid arthritis and 15 non-inflammatory joint diseases. Group differences were found for many baseline variables, but with considerable overlap between the groups. A set of four clinical and laboratory variables (elevated CRP, genitourinary symptoms, metatarsophalangeal joint involvement. HLA B27) could predict reactive arthritis with a sensitivity of 69.2% and a specificity of 93.5%. A wide range of clinical and laboratory examinations are required to determine the final diagnosis in oligoarthritis, but individual and sets of clinical and laboratory measures may give helpful clues for the correct diagnosis.

Musculoskeletal manifestations with panniculitis - a hospital based study on 62 patients in Kuwait

“…Whether primary or secondary to an obvious underlying cause, EN has been reported to be often associated with acute arthritis/periarthritis of ankle or with acute polyarthritis predominantly involving the lower segment of the body [4,8]. Although several authors have mentioned this as being mainly or exclusively a presentation of acute arthritis associated with sarcoidosis (often called Lofgren syndrome) [9,10,19], this was not the experience in the present study. Lofgren syndrome was found only in 2 patients.…”

HLA-B27-Associated Reactive Arthritis: Pathogenetic and Clinical Considerations

“…The diagnostic criteria for ReA shown in Table 6 were used in a recent study by Fendler et al (50) and resemble those used in other studies (71,107,113). It has been reported that elevated Creactive protein levels, genitourinary symptoms, metatarsophalangeal joint involvement, and HLA-B27 could predict the diagnosis of ReA with a sensitivity of 69.2% and a specificity of 93.5% (106).…”

Diagnostic and Predictive Value of Acute-phase Reactants in Adult Undifferentiated Peripheral Inflammatory Arthritis: A Systematic Review

“…The second study 16 investigated 146 patients with UA with the outcome measure defined as SpA after 24 weeks, based on CRP > 20 mg/l, HLA-B27 positivity, metatarsophalangeal involvement, and presence of genitourinary symptoms. Additional followup was established after 1 and 2 years.…”