Differential Diagnosis for Morning Stiffness in Arthritis
- Single most likely diagnosis
- Rheumatoid Arthritis (RA): This is the most common type of arthritis that causes morning stiffness, which typically lasts for more than an hour and improves throughout the day. The stiffness is often accompanied by swelling, pain, and warmth in the affected joints.
- Other Likely diagnoses
- Osteoarthritis (OA): Although OA is more commonly associated with stiffness after periods of inactivity (e.g., stiffness after sitting), some patients may experience morning stiffness, especially in advanced cases.
- Psoriatic Arthritis (PsA): Morning stiffness can be a symptom of PsA, which is often accompanied by skin and nail changes.
- Ankylosing Spondylitis (AS): AS is a type of spondyloarthritis that can cause morning stiffness, particularly in the spine and hips.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Septic Arthritis: Although rare, septic arthritis is a medical emergency that requires prompt diagnosis and treatment. Morning stiffness can be a symptom, but it is often accompanied by severe pain, swelling, and systemic symptoms such as fever.
- Lyme Arthritis: Lyme disease can cause arthritis, which may present with morning stiffness. It is essential to consider this diagnosis, especially in patients with a history of tick exposure.
- Rare diagnoses
- Rheumatic Fever: This is a rare complication of streptococcal infection, which can cause arthritis, including morning stiffness.
- Sjögren's Syndrome: This autoimmune disorder can cause arthritis, including morning stiffness, although it is more commonly associated with dry eyes and mouth.
- Mixed Connective Tissue Disease (MCTD): MCTD is a rare autoimmune disorder that can cause arthritis, including morning stiffness, as well as other systemic symptoms.