Approach to the patient with polyarthritis

When a patient has joint pain, the most important decision for the physician is to distinguish between an inflammatory or non-inflammatory process. The most common inflammatory polyarthritides include rheumatoid arthritis, psoriatic arthritis, systemic lupus erythematosus, and less likely, chronic tophaceous gout. Investigations usually help only to confirm a diagnosis already suspected. Generally, few symptoms are pathognomonic of a particular diagnosis. Follow up over several months to a year and anti-inflammatory medications, when indicated, are the mainstay of early management.