In the absence of trauma, acute monoarthritis is most likely to be caused by septic or crystalline arthritis.
In a febrile patient with a joint effusion, diagnostic arthrocentesis is mandatory. Inflammatory fluid, that is, a white blood cell count >2000/mm-\ should be considered infected until proven otherwise.
Gonococcal arthritis usually presents as a migratory tenosynovitis, often involving the wrists and hands, with few vesicopustular skin lesions. Nongonococcal septic arthritis is most often caused by Staphylococcus aureus and most often affects large weight-bearing joints.
Monosodium urate crystals in gout are needle-shaped and negatively birefringent (yellow) under the polarizing microscope. Calcium pyrophosphate dihydrate crystals in pseudogout are rhomboid and positively birefringent (blue).
Treatment of gout depends on the stage: nonsteroidal antiinflammatory drugs, colchicine, or steroids for an acute gouty arthritis, and urate lowering with probenecid or allopurinol during the intercritical period.
Was this article helpful?
It's time for a change. Finally A Way to Get Pain Relief for Your Arthritis Without Possibly Risking Your Health in the Process. You may not be aware of this, but taking prescription drugs to get relief for your Arthritis Pain is not the only solution. There are alternative pain relief treatments available.