Approach to Polyarthritis.
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Date
2010-09
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Abstract
A child with polyarthritis is always a diagnostic
challenge for the treating physician. By definition, polyarthritis,
taken in context as a subgroup of juvenile idiopathic arthritis, is
defined as inflammation of more than 4 joints on physical
examination. Though the exact incidence and prevalence of
polyarthritis in childhood is not known, it is not uncommon in
pediatric practice. Polyarthritis can be a clinical manifestation
of diverse disease processes and the differential diagnosis is
understandably very broad. It can be caused directly by an
infectious agent or indirectly by immune mechanisms, may be
a component of a systemic disease process or may be
idiopathic. The presentation can be acute or chronic. It can
represent a benign self limiting illness requiring no specific
treatment or may be a severely disabling condition with
significant morbidity and, in some cases, even mortality.While
in some situations it may be possible to arrive at a provisional
clinical diagnosis right at the outset, in others the diagnosis
gradually evolves over a period of time. As in most other
arthritides, the most important aspects of the diagnosis are a
thorough history and a detailed clinical examination. Relevant
laboratory investigations can help in facilitating the diagnosis
but can often also mislead the treating physician. Hereby we
present a clinical approach to a child with polyarthritis.
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Keywords
Polyarthritis, Children, Clinical approach
Citation
Singh Surjit, Mehra Sonia. Approach to Polyarthritis. Indian Journal of Pediatrics. 2010 Sept; 77(9): 1005-1010.