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Patients Presenting with a Hot, Swollen Joint: A Single-Centre Retrospective Analysis
Emanuele Chisari1,2, Khaled M Yaghmour1, Fidel Peat1
1Division of Trauma & Orthopaedics, Addenbrooke's Hospital, University of Cambridge, Cambridge, CB2 0QQ, United Kingdom.
Current Rheumatology Reviews
|January 23, 2019
Summary
Hot, swollen joints are often challenging to manage. This study found crystal-related conditions like pseudogout are more common than infection in these cases, highlighting a need for better diagnostic approaches.
Area of Science:
- Rheumatology
- Orthopedics
- Emergency Medicine
Background:
- Hot, swollen joints are a frequent clinical presentation in emergency departments (ED) and specialized clinics.
- Effective management of these cases can be challenging for healthcare providers.
Purpose of the Study:
- To conduct a single-center retrospective analysis of patients presenting with hot, swollen joints.
- To investigate the etiological factors contributing to joint inflammation over a three-month period.
Main Methods:
- Retrospective analysis of 36 patients presenting with hot, swollen joints to ED or elective clinics.
- Synovial fluid aspiration for microbiological and cytological analysis.
- Analysis included patient demographics, joint affected, and crystal/infection identification.
Main Results:
- Infection was identified in only 19.4% of synovial fluid samples.
- Crystal-induced arthritis was prevalent: 58.3% pseudogout (calcium pyrophosphates) and 11.1% gout (uric acid).
- Significant correlations found between age and pseudogout, and prior antibiotic use and ED presentation.
Conclusions:
- Crystal-related pathologies are a high-incidence cause of hot, swollen joints.
- Further clinical studies are necessary to improve management and diagnostic understanding.
- Enhanced understanding is crucial for specific patient populations presenting with these symptoms.
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