Differential Diagnosis for Multiple Severe Arthralgia
Single Most Likely Diagnosis
- Rheumatoid Arthritis (RA): This is a chronic autoimmune disorder characterized by symmetric, additive, and erosive arthritis. Multiple severe arthralgia is a hallmark symptom, often accompanied by morning stiffness and systemic symptoms like fatigue and fever.
Other Likely Diagnoses
- Osteoarthritis (OA): Although OA typically presents with less systemic symptoms compared to RA, severe cases can cause significant arthralgia, especially in weight-bearing joints and those with significant joint degeneration.
- Lupus: Systemic Lupus Erythematosus (SLE) is an autoimmune disease that can affect multiple systems, including the joints, causing arthralgia and arthritis. The joint symptoms in lupus can be similar to those in RA but are often less erosive.
- Fibromyalgia: Characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory, and mood issues. While the pain in fibromyalgia is not typically confined to the joints, it can cause significant arthralgia.
Do Not Miss Diagnoses
- Septic Arthritis: An infection within a joint, which is a medical emergency. Prompt diagnosis and treatment are crucial to prevent joint destruction and systemic complications.
- Gout or Pseudogout: These are forms of crystal-induced arthritis that can cause sudden, severe arthralgia, typically in one joint at a time but can be polyarticular. Missing these diagnoses can lead to unnecessary treatments and potential kidney damage from urate stones in gout.
- Lyme Disease: Caused by the bacterium Borrelia burgdorferi, transmitted to humans through the bite of infected black-legged ticks. Lyme disease can cause arthritis, particularly in the knee, and if untreated, can lead to more severe systemic symptoms.
Rare Diagnoses
- Relapsing Polychondritis: A rare autoimmune disorder characterized by recurring episodes of cartilage inflammation, which can affect various types of cartilage, including that found in joints, ears, nose, and trachea.
- Sarcoidosis: An inflammatory disease that affects multiple organs in the body, but can also cause arthritis and arthralgia as part of its symptomatology.
- Hemochromatosis: A genetic disorder characterized by excessive iron accumulation in the body, leading to various symptoms including arthralgia, particularly in the second and third metacarpophalangeal joints, resembling OA.