| Disease
|
Symptoms
|
Signs
|
Investigations
|
Distinguishing Features
|
| Rheumatoid arthritis
|
pain, swelling, stiffness more than 6 weeks
|
swelling/tenderness, especially wrists, MCP, MTP
|
RF positive in 70%
|
symmetric
|
| Psoriatic arthritis
|
pain, swelling, tenderness in joints and tendon/ligament attachment points
|
tenderness at tendon attachments, dactylitis
|
not helpful
|
may have sacroiliitis, spondylitis, plantar fascitis, DIP arthritis, nail pitting, onycholysis, and personal or family history of psoriasis
|
| Systemic lupus erythematosus
|
multisystem involvement (rash, pleurisy, etc.) and photosensitivity
|
often more tender than swollen
|
ANA positive, ENA may be positive, cytopenias common
|
nonerosive
|
| Remitting seronegative symmetrical synovitis with pitting edema
|
acute onset symmetric hand and foot swelling /stiffness
|
pitting edema of hands and feet
|
RF negative
|
good response to low-dose steroids
|
| Polyarticular gout
|
preceding history of episodic monoarticular arthritis for years
|
any joint can be affected, tophi often present
|
increased uric acid, with urate crystals in joint
|
risk factors for gout
|
