In:
International Journal of Rheumatic Diseases, Wiley, Vol. 17, No. 5 ( 2014-06), p. 502-510
Abstract:
To evaluate the clinical courses and outcomes of patients with monoarthritis and to investigate the predictive factors of clinical outcomes. Methods A retrospective analysis was performed of 171 patients with chronic monoarthritis at a single tertiary hospital between January 2001 and January 2011. Baseline characteristics, radiographic findings and the clinical course were reviewed. Results The most commonly involved joints were the knees (24.0%), followed by the wrists (22.8%) and ankles (18.7%). A final diagnosis was established in 74 (43.3%) patients. Thirty‐one (18.1%) patients were diagnosed with rheumatoid arthritis ( RA ), 23 (13.5%) with peripheral spondyloarthritis (SpA), and 19 (11.1%) with Behçet's disease ( BD ). Among 108 patients who were initially undiagnosed, 85 (78.7%) patients remained with undiagnosed monoarthritis, with relatively shorter symptom durations and requiring less treatment. The initially involved joint was a predictive factor for the final diagnosis: the wrist joint for RA (odds ratio [ OR ] 11.58, P 〈 0.001), the ankle joint for SpA ( OR 6.19, P 〈 0.001), and the knee joint for BD ( OR 3.43, P = 0.014). Bony erosion at baseline was associated with progression to oligo‐ or polyarthritis ( OR 2.88, P = 0.030) and with radiographic progression. Conclusions In patients presenting with monoarthritis, a final diagnosis was established in less than half of the patients, and a majority of undiagnosed patients showed benign clinical courses. The initially involved joint and the presence of erosion at baseline were predictors of the final diagnosis and of clinical outcomes.
Type of Medium:
Online Resource
ISSN:
1756-1841
,
1756-185X
DOI:
10.1111/apl.2014.17.issue-5
DOI:
10.1111/1756-185X.12259
Language:
English
Publisher:
Wiley
Publication Date:
2014
detail.hit.zdb_id:
2427877-4
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