What Is Polyarthritis?

  • Isha IshtiaqMaster of Science - MS, Biological sciences, University of Sialkot

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If you’re someone suffering from joint pain, swelling, and stiffness, then you may have arthritis. Arthritis means inflammation of the joints. When inflammation occurs in more than five joints, it’s called polyarthritis.

Polyarthritis, also known as polyarticular arthritis, is a painful condition caused by an acute illness or autoimmune disease. It can disturb the normal functioning of life and can become worse if not managed properly.

In this article, you’ll learn about the symptoms, causes, diagnosis, and treatment of polyarthritis. Keep reading - to study about how to manage this condition.

Overview

Polyarthritis is a term that comes from two Greek words:

  • “poly”, meaning “many” or “much”
  • “arthron”, meaning “joint”

Polyarthritis means having arthritis in many joints at the same time.1

What are symptoms of polyarthritis?

The main symptoms of polyarthritis include joint pain, swelling, stiffness and tenderness. But symptoms can differ slightly depending on the underlying type and may include:

  • Pain and aching particularly affecting the hands, wrists, elbows, knees, ankles, feet
  • Stiffness upon waking or after inactivity lasting 30+ minutes
  • Warmth, redness and puffiness around inflamed joints
  • Fatigue, loss of appetite, unintended weight loss
  • Low-grade fevers
  • General feelings of being unwell
  • In cases of reactive arthritis - eye redness, urethritis, diarrhea, sores in mouth
  • In psoriatic arthritis - scaly patches of psoriasis rashes on skin, nails

While pain and swelling come and go, chronic polyarthritis can lead to long-term deformities like joint misalignment over time without treatment.

Types of arthritis

Rheumatoid arthritis

Rheumatoid arthritis (RA) is one of the most prevalent forms of polyarthritis. It's an autoimmune disease where the immune system mistakenly attacks the synovium - the membrane surrounding joints.2

Inflammation caused by RA leads to painful swelling and stiffness of the wrists, hands, knees, and feet. Over time it can cause bone erosion, deformity, and loss of function. RA affects around 1% of the world's population.2

Psoriatic arthritis

Psoriatic arthritis (PsA) develops in approximately 20% of people with the skin condition psoriasis. Psoriasis causes scaly, crusty patches and rashes, while PsA leads to inflammation in joints, tendons and spine.3

Common locations of PsA include the fingers, spine, hips and knees. It can sometimes precede or follow the onset of psoriasis.3

Reactive arthritis

Reactive arthritis, also known as Reiter's syndrome, develops in response to an infection elsewhere in the body like the gut or genitals. It usually strikes 2-4 weeks after infection and may be triggered by bacteria like Salmonella, Shigella or Chlamydia.4

Additionally, it can cause eye inflammation, mouth ulcers and skin lesions. Joints commonly involved are knees, ankles, heels. Symptoms tend to come and go.4

Polyarticular juvenile idiopathic arthritis

Polyarticular juvenile idiopathic arthritis (JIA) is a type of arthritis that affects children under the age of 16. There are several subtypes of JIA, each with its own unique set of symptoms.5

Difference between polyarthritis and polyarthralgia

FeaturePolyarthralgiaPolyarthritis
DefinitionPain in multiple jointsInflammation in multiple joints
SymptomsJoint pain, stiffness, and tendernessJoint pain, swelling, redness, warmth, and stiffness
CausesInjuries, overuse, infections, certain medicationsAutoimmune diseases, infections, injuries
DiagnosisPhysical exam, medical history, imaging testsPhysical exam, medical history, blood tests, imaging tests
TreatmentRest, ice, compression, elevation, pain relievers, physical therapyMedications, physical therapy, surgery
ComplicationsNoneJoint damage, disability

Causes of polyarthritis

The causes of polyarthritis depend on the type and severity of your condition. However, some common causes are:

Autoimmune diseases

These are conditions where your immune system mistakenly attacks your own body’s cells and tissues.1

Some examples are:

Infections

These are conditions where you are infected by bacteria, viruses, fungi, or parasites that cause inflammation and damage to your joints.1

Some examples are:

Cancer

These are conditions where abnormal cells grow and divide uncontrollably in your body. Some types of cancer can affect your joints directly or spread from other parts of your body.1

Some examples are:

  • Osteosarcoma (bone cancer)
  • Lymphoma (cancer of the lymphatic system)
  • Leukemia (cancer of the blood cells)
  • Metastatic cancer (cancer that has spread to another organ)

Gout

This is a condition where you have high levels of uric acid in your blood. Uric acid is a waste product that forms when your body breaks down purines (substances found in some foods and drinks). When uric acid crystals build up in your joints, they cause sudden and severe pain called gouty arthritis.

Some general risk factors include:

  • Family history or genetic predisposition for certain types. First-degree relatives have twice the usual risk
  • Female gender – women are more prone to RA and PsA on average
  • Age – risk rises after 40 years but can occur at any age
  • Environmental exposures — smoking, certain toxins, stress

Diagnosis of polyarthritis

The diagnosis of polyarthritis includes the following tests:

Physical examination

During the physical examination, your doctor will carefully examine your affected joints, paying close attention to:6

  • Tenderness
  • Swelling
  • Range of motion
  • Warmth and redness

Laboratory tests

Blood tests play a crucial role in evaluating potential underlying causes of polyarthritis.6 Common lab tests include:

Imaging techniques

Imaging techniques provide detailed visualizations of the affected joints, allowing doctors to assess the extent of damage and identify specific patterns associated with different types of arthritis.6

Imaging techniques include:

Additional diagnostic considerations

Sometimes, additional diagnostic procedures may be necessary to rule out specific causes or obtain joint fluid samples for analysis.6 These procedures may include:

  • Arthrocentesis this procedure involves removing a small amount of fluid from a joint for further examination and laboratory testing
  • Synovial biopsy in rare cases, a small sample of synovial tissue (lining of the joint) may be removed for microscopic examination

Treatment for polyarthritis

As there is no cure for most polyarthritis types currently, treatment focuses on inducing and maintaining remission of symptoms through a variety of pharmacological and non-pharmacological methods. The goals are to:

  • Reduce joint inflammation, swelling, pain through medications
  • Slow structural joint damage progression
  • Improve range of motion and physical function
  • Decrease flares and return function to normal activities

Treatment choices vary based on diagnosis, disease activity, severity and individual factors. An effective plan involves a multidisciplinary team approach.

Medications

  • Over-the-counter medications: NSAIDs like ibuprofen for mild-moderate pain/swelling relief
  • Disease-modifying antirheumatic drugs (DMARDs): methotrexate, sulfasalazine, hydroxychloroquine - slow disease progression over time7
  • Biologics and JAK inhibitors: block specific proteins to reduce inflammation in severe, refractory cases like anti-TNF drugs
  • Corticosteroids: short term use during flares to rapidly decrease inflammation

Physical therapy

Stretching, strength exercises, aquatic therapy help maintain mobility, flexibility and muscle tone around inflamed joints. Occupational therapy aids daily tasks.8

Surgery 

Rarely indicated but joint surgery may be needed in the future like synovectomy to remove diseased tissue or joint replacement for severely damaged joints.

Prevention of polyarthritis

There are several lifestyle strategies that can help in prevention of polyarthritis.9

  • Eat a balanced diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats. For example, anti-inflammatory mediterranean-style diet
  • Drink plenty of water and avoid alcohol and caffeine
  • Exercise regularly and moderately to maintain your muscle strength and flexibility
  • Get enough sleep and rest to reduce stress and fatigue
  • Avoid smoking and exposure to second-hand smoke
  • Manage stress with relaxation techniques such as meditation, yoga, or breathing exercises
  • Ergonomic techniques and bracing heavy loads avoid overuse strain
  • Vaccination - protects from infections linked to reactive arthritis like salmonella and shigella 

Outlook of polyarthritis 

Recent advances in understanding disease mechanisms and novel targeted therapies now allow many people with polyarthritis to enjoy improved quality of life, limited disability and a near normal life expectancy.

Still, ongoing treatment adherence and monitoring for complications remain crucial due to risks like:6

  • Worsening joint damage/deformation from inadequate inflammation control 
  • Accelerated disability and loss of function
  • Comorbid conditions: weight gain, cardiovascular issues, metabolic syndrome 
  • Other autoimmune disorders developing simultaneously in some individuals
  • Psychological implications like depression from chronic pain

Regular follow-ups with a rheumatologist ensure individuals stay on track with disease management. New research continues enhancing prognosis through optimized prevention and precision-care strategies. With a coordinated team approach, individuals with polyarthritis can hope to lead an active, fulfilling life.

FAQs

What is a diet for persons with polyarthritis?

While there's no one-size-fits-all diet for polyarthritis-affected individuals, there are some general guidelines that might help ease your symptoms. Eat lots of fruits, veggies, and whole grains, and less processed foods, sugary drinks, and red meat.

What is the difference between polyarthritis and rheumatoid arthritis?

Polyarthritis is a general term that refers to inflammation of multiple joints. Rheumatoid arthritis is a specific type of autoimmune arthritis that is characterized by inflammation of the lining of the joints.

What is inflammatory polyarthritis?

Inflammatory polyarthritis is a type of polyarthritis that is characterized by inflammation of the joints.

What are the complications of polyarthritis?

Complications of polyarthritis can include joint damage, disability, and fatigue. Polyarthritis can also increase the risk of heart disease, osteoporosis, and other health problems

Is polyarthritis a disability?

Polyarthritis can be a disabling condition, depending on the severity of symptoms. People with severe polyarthritis may have difficulty walking, dressing, and performing other daily activities.

Summary

In a nutshell, polyarthritis can affect your quality of life and lead to serious complications if left untreated or poorly controlled. Recognizing the signs and symptoms of polyarthritis and seeking medical attention early on is crucial for timely diagnosis and appropriate treatment. Early intervention can help alleviate symptoms, prevent joint damage, and improve your overall well-being. You can also take steps to prevent or manage polyarthritis by following a healthy lifestyle and taking medications as prescribed.

References

  1. Alpay-Kanıtez N, Çelik S, Bes C. Polyarthritis and its differential diagnosis. Eur J Rheumatol [Internet]. 2019 Oct [cited 2023 Nov 17];6(4):167–73. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6812894/
  2. Guo Q, Wang Y, Xu D, Nossent J, Pavlos NJ, Xu J. Rheumatoid arthritis: pathological mechanisms and modern pharmacologic therapies. Bone Res [Internet]. 2018 Apr 27 [cited 2023 Nov 17];6:15. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5920070/
  3. Tiwari V, Brent LH. Psoriatic arthritis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 [cited 2023 Nov 17]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK547710/
  4. Pennisi M, Perdue J, Roulston T, Nicholas J, Schmidt E, Rolfs J. An overview of reactive arthritis. JAAPA. 2019 Jul;32(7):25–8. 
  5. Oberle EJ, Harris JG, Verbsky JW. Polyarticular juvenile idiopathic arthritis – epidemiology and management approaches. Clin Epidemiol [Internet]. 2014 Oct 24 [cited 2023 Nov 17];6:379–93. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4216020/
  6. Akhondi H, Gupta N. Polyarticular arthritis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 [cited 2023 Nov 17]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK537170/
  7. Köhler BM, Günther J, Kaudewitz D, Lorenz HM. Current therapeutic options in the treatment of rheumatoid arthritis. J Clin Med [Internet]. 2019 Jun 28 [cited 2023 Nov 17];8(7):938. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6678427/
  8. Meghe S, Chitale N, Phansopkar P, Joshi A. Effectiveness of early physical therapy rehabilitation in patient with juvenile rheumatoid arthritis. Cureus [Internet]. [cited 2023 Nov 17];14(10):e30213. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9650644/
  9. Finckh A, Deane KD. Prevention of rheumatic diseases: strategies, caveats and future directions. Rheum Dis Clin North Am [Internet]. 2014 Nov [cited 2023 Nov 17];40(4):771–85. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4250827/

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Isha Ishtiaq

Master of Science - MS, Biological sciences, University of Sialkot

Isha Ishtiaq is a versatile medical writer and storyteller who brings the world of medicine to life. With her deep understanding of Biotechnology and Biological Sciences, she crafts content that’s not only informative but also engaging. Over the years, she has honed her skills by crafting diverse content, including blogs, research papers, and review articles, catering to clients worldwide. Her goal is clear: to be at the forefront of technological advancements in the industry, ensuring that her audience receives top-notch, up-to-date content. Her writing is a blend of precision and passion, reflecting her commitment to educating and inspiring her readers. When you engage with her work, you can be confident that you're in the hands of a writer who is not just skilled but driven by a profound passion for her craft.

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