Viral Arthritis

This week at CUH MR, we talked about viral arthritis:

– Viral arthritis – responsible for about 1% of all cases of acute arthritis

– World-wide, parvovirus B19, hep B / C, HIV, and arboviruses (specifically alphaviruses, which includes chikungunya) are the most important causes of virally mediated arthritis

  • Most commonly, viruses will cause a symmetric polyarthritis (similar in distribution to RA); HIV – arthralgias are more common than true arthritis

– Serologic testing may help the diagnosis but also helpful are associated clinical features that point to a specific virus (slapped cheek rash in parvovirus; jaundice related to hepatic injury in hepatitis viruses)

– Treatment goals are relief of symptoms and maintenance of function: acetaminophen / NSAIDs in doses typically used in inflammatory arthropathy like RA; steroids are discouraged because of limited utility in most viral arthritis; there is no role for anti-virals because the illness is self-limited in most cases