Monoartrite aguda na prática médica: revisão de literatura

The presence of a monoarticular inflammatory process—characterized by edema, pain, hyperemia, and increased local temperature—is diagnostic of monoarthritis. The etiological diagnosis of acute monoarthritis must take into account the presence and severity of joint inflammation, the rate of symptom onset, the patient’s epidemiological and demographic risk factors, and whether there is systemic involvement. It should be noted that the primary differential diagnoses are septic arthritis and gouty arthritis. In adults with septic arthritis, the knee is affected in approximately 50% of cases, whereas in children, the hip is the most frequently involved joint. Gonococcal arthritis can manifest in two distinct ways: either as a triad of tenosynovitis, dermatitis, and polyarthralgia (without purulent arthritis), or as purulent arthritis (without cutaneous lesions). Acute gouty arthritis typically presents as an extremely painful, nocturnal, monoarticular episode affecting the first metatarsophalangeal joint; it lasts 5 to 7 days, with pain intensity peaking within the first 12 hours. The etiological diagnosis of monoarthritis is established through the analysis of synovial fluid obtained via arthrocentesis: a positive culture indicates septic arthritis, while the presence of crystals indicates gout. Antibiotic therapy for septic arthritis is targeted at the specific causative agent—most commonly *Staphylococcus aureus* or *Neisseria gonorrhoeae*. Joint drainage is indicated for patients with significant septic arthritis. Currently, non-steroidal anti-inflammatory drugs (NSAIDs) and glucocorticoids are the treatments of choice for gouty arthritis.