polyarthritis is also called multi-joint Arthritis or inflammatory polyarthritis. It is defined as arthritis or joint pain affecting five or more joints at the same time.
This term describes the number of joints involved: poly means a lot. Polyarthritis may be permanent or temporary (temporary), but it always affects more than five joints.
Polyarthritis is most often associated with autoimmune diseases such as rheumatoid arthritis (RA). However, certain viral infections can also trigger it.
This article explains the symptoms, causes, diagnosis, and treatment of polyarthritis.
Symptoms of polyarthritis tend to be similar to those of rheumatoid arthritis and other autoimmune diseases. They can develop suddenly or last for months.
signs of joint inflammation
Signs of joint inflammation often include swelling, heat, pain, and reduced range of motion.
Morning stiffness and pain that improve with activity and worsen with rest are typical symptoms of inflammatory arthritis.
Other symptoms include:
- loss of appetite
- swollen lymph nodes
- Temperature 100.4 degrees or above
- tiredness or lack of energy
- unexpected weight loss
Polyarthritis can be caused by an autoimmune disease or an acute illness.
Polyarthritis is most often caused by autoimmune diseases.
What is an autoimmune disease?
In autoimmune diseases, the immune system mistakenly attacks its cells and tissues. The causes of autoimmune diseases are unknown, but are closely related to genetics and the environment.
Autoimmune diseases tend to trigger a systemic response because they are systemic diseases with different symptoms. Therefore, multi-joint involvement usually does not occur in isolation like osteoarthritis. Instead, there are many other important symptoms, such as a rash.
The autoimmune diseases most commonly associated with polyarthritis include:
- juvenile idiopathic arthritis
- psoriatic arthritis
- Rheumatoid Arthritis
Polyarthritis can also occur as part of an acute illness, such as:
- rheumatic fever
- Alphavirus infections, including Ross River virus, Chikungunya virus, and Mayaro Virus
- Zika virus
- Epstein-Barr virus (EBV)
- Cytomegalovirus (CMV)
In these cases, inflammation may move between multiple joints.
Polyarthritis is most often caused by autoimmune diseases such as arthritis and lupus. But it can also be triggered by acute illnesses, such as rheumatic fever.
Because polyarthritis is most often associated with autoimmune diseases, your healthcare provider will usually first try to pinpoint the underlying cause of your joint pain. Joint inflammation, tenderness, fluid in the joints (called knee hydrops), and swelling are common signs of autoimmune disease.
Symmetry and Asymmetry
Your healthcare provider will assess whether your pain is symmetrical (for example, symptoms appear in your hands or knees) or asymmetrical (symptoms in only one joint). People with rheumatoid arthritis tend to have symmetrical symptoms. People with psoriatic arthritis often experience asymmetrical symptoms.
Blood tests may be needed to help narrow the diagnosis. Tests to screen for RA usually include:
- Rheumatoid factor test
- anti-cyclic citrullinated peptide (Anti-CCP) Antibody Test
Also, your healthcare provider may check your blood:
- Elevated white blood cell count
- Elevated platelets
- Increased markers of inflammation called erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP)
Serological testing may also be helpful in finding specific antibodies associated with related autoimmune diseases. Your healthcare provider will also test for the virus if an infectious cause is suspected.
Depending on the suspected cause, X-rays, musculoskeletal ultrasound, magnetic resonance imaging (MRI), and synovial fluid analysis (also known as Arthrocentesis) may be helpful.
To diagnose polyarthritis, a healthcare provider will try to understand the underlying cause of your symptoms. They will then determine if your symptoms are symmetrical, do blood tests, and possibly order imaging tests.
Treatment for polyarthritis is usually the same as for autoimmune diseases. They include medicines to treat pain and inflammation, medicines to inhibit disease progression, and home remedies.
Nonsteroidal anti-inflammatory drugs (NSAIDs) such as Advil (ibuprofen), Aleve (naproxen), and Voltaren (diclofenac) can help relieve pain and stiffness.
In addition, disease-modifying antirheumatic drugs (DMARDs) can help slow the progression of autoimmune diseases. For example, healthcare providers often prescribe methotrexate to reduce joint damage from polyarthritis.
Biologics, including Remicade (infliximab) and Enbrel (etanercept), can alter the immune system to reduce inflammation. Additionally, corticosteroids help control inflammation and reduce pain.
You can take steroids by mouth or by injection. They should only be used in the short term as they can cause serious side effects.
Thermotherapy can temporarily relieve symptoms. These include:
- warm bath
- winter gloves
- Over-the-counter (OTC) topical creams such as Aspercreme
Also, don’t underestimate the value of exercise in treating polyarthritis. Low-intensity activities like swimming, yoga, and stretching help keep your joints healthy.
Treatment of polyarthritis may involve drugs that reduce pain and inflammation and inhibit disease progression. Also, home remedies and exercise may help.
Polyarthritis is a type of arthritis that affects five or more joints. Joint pain and inflammation are the most common symptoms, but symptoms can also include a rash, fever, and fatigue. It is most commonly caused by autoimmune diseases, but can also be caused by acute infections. Treatment includes medication, home comfort measures, and exercise to keep the joints mobile.
It is important to treat polyarthritis before the condition worsens and causes permanent joint damage. In rare cases, polyarthritis can lead to scarring of the lungs, dry eyes, rashes, and pericarditis (inflammation of the sac around the heart). Call your healthcare provider if you have pain in five or more joints.
Frequently Asked Questions
How is polyarthritis treated?
Treatment of polyarthritis is similar to arthritis and other autoimmune diseases. Potential treatments include disease-modifying antirheumatic drugs (DMARDs), nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, surgery, medications, massage, and heat.
What is migratory polyarthritis?
Migrating polyarthritis is when arthritis gradually spreads to different joints. Arthritis can start in one or two joints, appear to improve after a few days, but then return and affect a different set of joints. When symptoms last less than six weeks, it is considered acute polyarthritis, and if symptoms last longer, it may be chronic.
How many people have JIA?
In 2019, a total of 294,000 children in the United States had juvenile idiopathic arthritis (JIA). The seven types of JIA exhibit unique symptoms that can affect many joints. The exact reason is unclear.