[The main directions in case of polyarthritis]

The polyarthritis is a relatively frequent situation which can translate a whole set of diverse and varied etiologies. A careful history and physica examination are key to accurate diagnosis of polyarthritis: the context, the topography of the articular involvement, the existence of general signs and extra-articular signs are crucial. It is advisable first of all to eliminate the infectious disease especially in case of fever (endocarditis). It is also necessary to look for a microcrystalline arthritis (gout, chondrocalcinosis) which the treatment justifies specific measures. Once these spread diagnoses, we can envisage an inflammatory rheumatism chronic and first of all, a rheumatoid arthritis (symmetric bilateral polyarthritis affecting hands and respecting distal interphalangeal joints). The rheumatoid arthritis is an urgency diagnosis: it requires an early, specialized, individualized and multidisciplinary care. The rapid institution of a disease-modifying antirheumatic drug can allow obtain a remission, mproves clinical outcomes and reduces the accrual of joint damage and disability.