Abstract
The work-up of acute monoarthritis is challenging due to the abundance of differential
diagnoses. In addition to a bacterial septic arthritis, which can, if not treated
promptly, cause rapid irreversible joint damage, many diseases have to be considered:
inflammatory rheumatic diseases, activated osteoarthritis, other infectious arthritis,
cristal induced arthritis, and rare tumorous diseases. In cases with high urgency,
and/or when medical history, physical examination and laboratory parameters remain
without a specific etiologic clue, septic arthritis has to be excluded by immediate
diagnostic joint aspiration. In many patients the cause of monoarthritis can already
be determined by ordering a leucocyte count of the synovial fluid sample, a microscopy
for crystals, and gram staining and culture for bacterial pathogens.
Es gibt zahlreiche Differenzialdiagnosen zur Monarthritis: Entzündlich-rheumatische
Erkrankungen, eine aktivierte Arthrose, andere infektiöse Arthritiden, Kristallarthritiden
oder auch seltene tumoröse Erkrankungen. Vor allem aber ist die bakteriell bedingte
septische Arthritis auszuschließen, die unbehandelt rasch zu irreversiblen Schäden
führt. Bei unklarer Ätiologie ist hier die sofortige diagnostische Gelenkpunktion
Mittel der Wahl.
Schlüsselwörter
Monarthritis - septische Arthritis - Arthrozentese - Gicht - Kristallarthropathie
Key words
bacterial arthritis - septic arthritis - gout - crystal arthropathies - arthrocentesis
