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Polyarthritis can be defined as the condition when five or more joints are impacted by joint discomfort. Because there are numerous possible reasons, symptoms might differ greatly from one person to the next. This condition could arise from autoimmune of the body or due to many other factors that influence a person’s lifestyle. The symptoms range from pain to weight loss which may develop over a period of time or maybe a sudden onset of the disease. It is advisable to visit a doctor when doing daily activities becomes difficult and there is pain or inflammation in the joints.
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Key Terms: Polyarthritis, Joints, Inflammation, Disease, Chronic Disease, Rheumatoid Arthritis, Autoimmunity
What is Polyarthritis?
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When at least five joints are affected by arthritis, the term polyarthritis is used. Polyarthritis can be caused by a variety of illnesses, including rheumatoid arthritis and infection. Differential diagnosis relies heavily on anamnesis (medical history), physical examination, laboratory results, and imaging techniques.
- Generally, our body has the ability to differentiate between foreign particles and self-cells which is attributed to the memory cells in our immune system. Under certain unknown conditions, the body is unable to self-cells from foreign ones and starts attacking the body’s own cells leading to a condition referred to as autoimmunity.
- Rheumatoid Arthritis (RA) is a chronic autoimmune disease that causes joint inflammation, swelling, and discomfort. Rheumatoid Arthritis primarily affects small joints like the hands and feet, although it can also affect larger joints later on. A symmetrical pattern of joint involvement is frequent. If this condition starts to affect more than five joints, it is called polyarthritis.
Types of Polyarthritis
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Mentioned below are the different types of polyarthritis:
- Polyarticular Juvenile Idiopathic Arthritis (JIA): Juvenile idiopathic arthritis, or JIA, is a type of polyarthritis that affects children and teenagers from infancy through late adolescence. From ankles, wrists, and hands to hips and knees, it can cause excruciating pain in little and major joints. It can even happen in the neck and jaw. JIA might be difficult to diagnose because doctors aren't always sure what causes it. It is a disorder that, in many situations, improves with time and proper treatment.
- Lupus: This type of polyarthritis affects a person's skin, kidneys and central nervous system (CNS) in addition to their joints.
- Psoriatic Arthritis: As the name implies, psoriatic arthritis can affect persons who suffer from psoriasis. Arthritis can emerge first in some cases. A scaly, red rash and swelling of the fingers and toes into a ‘sausage shape’ on one side of the body are some of the symptoms to watch for.
Causes of Polyarthritis
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Mentioned below are the common causes of Polyarthritis:
- Rheumatoid arthritis
- Cancer
- Parvovirus
- Lupus
- Still’s disease
- Chikungunya
- Whipple’s disease
- Gout
- Sarcoidosis
- Ross river virus
Symptoms of Polyarthritis
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Mentioned below are the common symptoms of Polyarthritis:
- Inflammation in affected areas
- Pain
- Stiffness
- Rashes
- Profuse sweating
- Loss of appetite
- Fatigue
- Fever
- Weight loss
Diagnosis of Polyarthritis
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Doctors generally look for inflammation near the joints, rashes, tenderness of the affected area, lymph node swelling and symmetric/asymmetric (when arthritic symptoms appear on both sides of the body, it is known as symmetric pain and vice versa) patterns of pain.
Treatment of Polyarthritis
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Mentioned below are a few methods of treatment of polyarthritis:
- Anti-inflammatory Drugs: Corticosteroids and disease modifying antirheumatic drugs such as DMARDs (suppress immune response) and Hydroxychloroquine (immune modulator), non-steroidal anti-inflammatory drugs such as NSAIDs (blocks enzymes and proteins involved in inflammation) and anti-TNF drugs (Tumour necrosis factor) are used when DMARDs are not effective.
- Topical Medications to Relieve Pain: Capsaicin supplements, diclofenac, arnic and aspercreme.
- Any kind of stretching exercise or swimming can also help with reducing polyarthritis symptoms. Warm baths may also aid with arthritis pain discomfort.
Conditions Associated with Polyarthritis
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Polyarthritis is a general term for a group of conditions, and patients with it may initially appear to their doctor with another issue. Early polyarthritis, for example, might make a person feel exhausted or sick. Some diseases can occur as a result of polyarthritis or as a symptom of another issue. Among them are:
- Fibromyalgia: This is a disorder that affects the entire body, producing pain and exhaustion in a variety of locations, including the muscles.
- Dupuytren’s Contracture: This is a condition that occurs when contraction of the connective tissue in the hand is seen which may cause the person’s fingers to curl.
- Hemochromatosis: Polyarthritis can occur if the body accumulates too much iron instead of utilising it.
- Raynaud’s Disease: When there is an improper circulation of blood in the hands and feet, fingers may turn white, red or purple.
- Inflammatory Bowel Disease (IBD): Crohn’s disease and ulcerative colitis are types of IBD that involves inflammation of the intestine and colon.
Things to Remember
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- Polyarthritis is a condition in which at least five joints are affected by arthritis. Rheumatoid arthritis and infection are two common causes of polyarthritis.
- Rheumatoid Arthritis (RA) is an autoimmune illness that causes swelling, inflammation, and pain in joints which affects tiny joints like the hands and feet.
- Polyarthritis is of three types, namely, JIA (affects infants), Lupus (affects CNS. Skin and kidneys along with joints) and psoriatic arthritis (affects people who suffer from psoriasis).
- While there is no cure for polyarthritis, it may be controlled with therapy and a change in lifestyle.
- Not smoking, maintaining a healthy weight, protecting joints, exercise, and obedience with treatment regimen are some common lifestyle modifications that can help one manage the symptoms of polyarthritis.
- Anti-inflammatory drugs are used to help reduce inflammation, which is temporary.
- Patients initially often present to the clinic with various other symptoms that end up being diagnosed as polyarthritis.
- If left uncontrolled, it leads to various other detrimental conditions such as heart attack and stroke.
Sample Questions
Ques. What are the causes and symptoms of polyarthritis? (3 marks)
Ans. The common causes and symptoms of polyarthritis include:
- Joint pain and stiffness are the two most common symptoms of polyarthritis, and they usually become worse as one gets older.
- Osteoarthritis and rheumatoid arthritis are the most frequent kinds of arthritis leading to polyarthritis.
- The firm, slick tissue that covers the ends of bones where they meet to create a joint breaks away as a result of osteoarthritis.
Ques. What is the difference between polyarthritis and arthritis? (5 marks)
Ans. Polyarthritis, inflammatory arthritis, and rheumatoid arthritis (RA) are all terminology that are frequently interchanged. While they are connected, they are not synonymous. RA is a disease, but the other two are terms used to describe a specific type of arthritis that depends on the number of joints that are affected and the onset of the disease.
- Rheumatoid Arthritis: Rheumatoid arthritis is a chronic autoimmune illness that produces inflammation in the joints and other body parts. When a person's immune system destroys his or her own cartilage and joint lining capsule, it causes arthritis. Hands, ankles, and elbows are commonly affected by rheumatoid arthritis. The degeneration of two opposing bones is the end result. Adolescents and young adults are the most likely to have it (individuals aged 20 and over).
- Inflammatory Arthritis: Inflammatory arthritis is an autoimmune illness in which the immune system misidentifies and assaults its own bodily tissues, mistaking them for harmful germs or viruses.
- Polyarthritis: Polyarthritis is most commonly caused by auto-immune diseases such rheumatoid arthritis, amyloidosis, psoriatic arthritis, and lupus erythematosus, but it can also be caused by an alphavirus infection like chikungunya virus or Ross River virus. Alphavirus polyarthritis syndrome is the name given to this ailment.
Ques. List the different types of treatments available for polyarthritis. (3 marks)
Ans. Polyarthritis is not curable but treatments may be taken to reduce the discomfort. The ways to reduce discomfort experienced by the patient are as follows
- Antibiotics and medicines (anti-inflammatory drugs and topical medication)
- Stretching and exercises
- Swimming
- Surgery for joint replacement
- Massages or acupressure treatments
- Non-pharmacological treatments such as educating the patient, therapy sessions for mental health, appropriate amount of rest and physical activity, careful intake of nutrition and dietary supplements.
Ques. What are the possible ways to classify polyarthritis? (3 marks)
Ans. As there are various factors involved in the onset of polyarthritis, this disease can be classified based on the following categories:
- Duration: short term (acute: less than 6 weeks) or long term (chronic: more than 6 weeks)
- Type of joints affected: Large (knees, ankles etc) or small (wrists, fingers etc)
- Symmetric or Asymmetric
- Clinical Pattern: Migratory (initially appears in a spot, recovers and affects another area), additive (joints involved together within days), intermittent (onset of the disease is followed by complete improvement, after which recurrence of the disease occurs and severity of the disease improves progressively).
Ques. What kind of radiological methods can be used for diagnosis of polyarthritis? (2 marks)
Ans. There are various radiological methods that can be used to diagnose a patient suffering from polyarthritis. They include:
- Ultrasound
- Magnetic resonance imaging (MRI)
- X-ray
- CT (computed tomography) scan
Ques. What are the various types of drugs that can be used for the treatment of polyarthritis? (3 marks)
Ans. There are different kinds of drugs that can be used for the treatment of polyarthritis such as:
- Antimicrobials (rifampicin, tetracyclines, quinolones)
- Immune checkpoint inhibitors
- Anti-diabetic DPP-4 inhibitors (linagliptin, alogliptin, sitagliptin)
- Chemotherapeutics (aromatase inhibitors – anastrozole, letrozole; taxanes – paclitaxel, docetaxel)
- Psychotropic 5-HT2A antagonists (mianserin, mirtazapine)
Ques. How is polyarthritis diagnosis? (2 marks)
Ans. Because the early signs and symptoms of rheumatoid arthritis are similar to those of many other diseases, it can be difficult to identify. The diagnosis cannot be confirmed by a single blood test or physical examination. Your doctor will look for swelling, redness, and warmth in your joints during the physical exam. Under few circumstances, the doctor may conduct a radiological examination in order to precisely assess the cause of the discomfort.
Ques. What is the CCP antibody test and what is it used for? (2 marks)
Ans. This test examines the blood for antibodies to CCP (cyclic citrullinated peptide). CCP antibodies, commonly known as anti-CCP antibodies, are an autoantibody. Healthy joint tissues are targeted by CCP antibodies. Antibodies to CCP can be a symptom of rheumatoid arthritis if they're present in your blood. Rheumatoid arthritis is an autoimmune illness that affects the joints and causes pain, swelling, and stiffness. Rheumatoid arthritis patients with CCP antibodies make up more than 75% of the population. They're nearly seldom found in persons who aren't sick.
Ques. What is juvenile idiopathic arthritis? What are its causes? (3 marks)
Ans. JIA (juvenile idiopathic arthritis) is a kind of arthritis that affects youth. Arthritis causes swelling (inflammation) and stiffness in the joints. JIA is a kind of arthritis that affects one or more joints in a kid aged 16 or younger for at least 6 weeks. Unlike adult rheumatoid arthritis, which is persistent and lasts a lifetime, JIA is usually outgrown by youngsters. However, in a growing kid, the condition might damage bone growth. Several factors can induce JIA. Genes and the environment are examples of such factors. This indicates that the disease might run in families and be brought on by particular triggers. Part of the HLA antigen DR4 gene is associated with JIA. This antigen may increase a person's chances of contracting the illness.
Ques. What are the complications associated with Polyarthritis? (2 marks)
Ans. Other organs and parts of the body can be badly impacted if polyarthritis is not effectively treated or controlled. The following are some of the effects on various parts of the body:
- Shortness of breath and a persistent cough might be caused by scarring on the lungs
- Dry eyes or inflammation of sclera of the eye
- Rashes on skin
- Inflammation of the heart lining
- Heart attacks
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