Gears and Cogs Representing the Many Joints

Many people are familiar with what rheumatoid arthritis is and the joint pain that it causes.1 But polyarticular rheumatoid arthritis is the specific form of this disease that affects multiple joints.2 In fact, this condition is defined as having pain in four, five, or more joints. Here are some key facts to know about polyarticular rheumatoid arthritis and its relationship to rheumatoid arthritis.

How Polyarticular Rheumatoid Arthritis Relates to Rheumatoid Arthritis

The term “oligoarticular” describes pain involving less than four joints.3 However, “polyarticular” is defined as having pain in multiple joints, at least four or five. This type of pain can be caused by inflammatory disorders like rheumatoid arthritis and psoriatic arthritis. It can also be caused by noninflammatory disorders and hypermobility syndromes.

It is very possible to have a chronic polyarticular form of rheumatoid arthritis. However, acute polyarticular arthritis is more often due to a viral infection or gout.4,5,6 Both children and adults can develop polyarticular arthritis.

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Joints Affected by Polyarticular Rheumatoid Arthritis

Polyarticular arthritis often involves peripheral joints and axial joints.7 The knee, hip, ankle, shoulder, and elbow are all examples of peripheral joints. Several of these joints can be simultaneously painful for someone suffering from polyarticular arthritis.

Meanwhile, rheumatoid arthritis typically affects the hands and feet more than anything else. Since rheumatoid arthritis is an autoimmune disorder, it occurs when the immune system attacks the body and can also affect the heart, lungs, and blood vessels.1

Diagnosing Polyarticular Arthritis

It is important for physicians to correctly diagnose polyarticular arthritis by distinguishing between true articular pain and non-articular or periarticular conditions.2,8 Physicians must also be able to tell the difference between polyarticular pain that originates from inflammation and pain that does not.

A proper review of the symptoms should make this distinction clear and guide the method of treatment recommended. Laboratory tests may be required to evaluate antinuclear antibodies, C-reactive protein, serum uric acid, synovial fluid, and infection.

Treatments for Polyarticular Rheumatoid Arthritis

Immunosuppression and antibiotics are recommended for individuals who have systemic inflammatory diseases causing the polyarticular arthritis.9 Joint inflammation can be treated with NSAIDs,2,8  such as ibuprofen, and joint pain can be soothed by arthritis creams like JointFlex. Acetaminophen may also help to treat pain that is not accompanied by inflammation.

Immobilizing affected joints with splints or slings can help reduce pressure.2 However, continued physical activity is recommended for chronic polyarticular rheumatoid arthritis sufferers to prevent stiffness and maintain good range of motion.

Living with Polyarticular Rheumatoid Arthritis

Ultimately, the big distinction between polyarticular arthritis and other forms of the disease are the number of joints affected. Whether joint pain is one-sided of symmetrical and whether extra-articular symptoms are present are also key factors in diagnosing this condition.

The recommended treatments vary greatly from one patient to the next because of the different joints that can be affected and the combinations of joints experiencing pain. In cases of polyarticular rheumatoid arthritis, multiple joints in the hands, fingers, feet, and toes are often affected, which can make daily tasks a challenge. Individuals with pain in multiple joints should discuss a multi-pronged strategy for addressing the various pain regions in the body with a trusted doctor.

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REFERENCES for POLYARTICULAR RHEUMATOID ARTHRITIS
1. Rheumatoid arthritis (RA). The Merck Manual: Consumer Version. Retrieved October 21, 2018 from https://www.merckmanuals.com/home/quick-facts-bone,-joint,-and-muscle-disorders/joint-disorders/rheumatoid-arthritis-ra.
2. Villa-Forte, A. (2017 December). Joint pain: Many joints. The Merck Manual: Consumer Version. Retrieved October 21, 2018 from https://www.merckmanuals.com/home/bone,-joint,-and-muscle-disorders/symptoms-of-musculoskeletal-disorders/joint-pain-many-joints.
3. Oligoarticular arthritis. About Kids Health. Retrieved October 21, 2018 from https://www.aboutkidshealth.ca/Article?contentid=1052&language=English.
4. Nwachuku, A. U. (2016 June 14). Is my joint pain caused by rheumatoid arthritis or an infection? Veritas Health. Retrieved October 21, 2018 from https://www.arthritis-health.com/types/rheumatoid/my-joint-pain-caused-rheumatoid-arthritis-or-infection.
5. Gout. MedlinePlus. Retrieved October 18, 2018 from https://medlineplus.gov/gout.html.
6. Edwards, N. L. (2018 May). Gout. The Merck Manual. Retrieved October 18, 2018 from https://www.merckmanuals.com/home/bone,-joint,-and-muscle-disorders/gout-and-calcium-pyrophosphate-arthritis/gout.
7. Mettier, S. R. (1955 March). Rheumatoid arthritis—Diagnosis in peripheral joint affliction. California Medicine, 82, 181-185. Retrieved October 21, 2018 from National Center of Biotechnology Information https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1532764/?page=1.
8. Pujalte, G. G. A., & Albano-Aluquin, S. A. (2015 July 1). Differential diagnosis of polyarticular arthritis. American Family Physician, 92, 35-41. Retrieved October 21, 2018 from https://www.aafp.org/afp/2015/0701/p35.html.
9. Inflammatory arthritis. Arthritis Foundation. Retrieved October 21, 2018 from https://www.arthritis.org/about-arthritis/types/inflammatory-arthritis/.

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