One joint affected by pain, swelling, overlying redness, stiffness and local heat
Monoarthritis One joint affected by pain, swelling, overlying redness, stiffness and local heat (±fever). Acute septic arthritis Suggested by: extremely painful, hot red joint, high fever. Confirmed by: increased WBC . Joint aspiration: synovial fluid turbid. Culture growing staphylococcus or streptococcus or pseudomonas or gonococci or TB, etc. Gout Suggested by: one acutely inflamed joint (usually small esp. big toe) at a time, but other joints in hands, arms, legs, and feet deformed. Tophi on ears and tendon sheaths. Confirmed by: serum urate Increase ( not always). Urate crystals (negatively birefringent in plane-polarised light) present on joint aspiration . Pseudogout (Ca 2+ pyrophosphate arthropathy/ chondrocalcinosis) Suggested by: one painful joint (usually knee) especially in elderly or history of hyperparathyroidism or myxoedema or osteoarthritis or haemochro-matosis or acromegaly. Confirmed by: joint aspiration: sy...