Rheumatic Fever: Or something else? Differential Diagnosis

Blood, blood-forming organs – immune system (D50-D90).

  • Löfgren’s syndrome – subtype of sarcoidosis; characteristic triad (simultaneous appearance of three symptoms): erythema (synonyms: nodular erythema, dermatitis contusiformis, erythema contusiforme; plural: erythemata nodosa; granulomatous inflammation of the subcutis (subcutaneous fat tissue), also known as panniculitis, and a painful nodule (red to blue-red color; later brownish). The overlying skin is reddened. Localization: both lower leg extensor sides, on the knee and ankle joints; less frequently on the arms or buttocks), bihilary lymphadenopathy and arthritis; primarily young people are affected.
  • Sarcoidosis (synonyms: Boeck’s disease; Schaumann-Besnier’s disease) – systemic disease of connective tissue with granuloma formation (skin, lungs and lymph nodes).

Endocrine, nutritional and metabolic diseases (E00-E90).

  • Hemochromatosis (iron storage disease) – genetic disease with autosomal recessive inheritance with increased deposition of iron as a result of increased iron concentration in the blood with tissue damage.

Infectious and parasitic diseases (A00-B99).

Musculoskeletal system and connective tissue (M00-M99).

  • Activated osteoarthritis – inflammatory thrust of degenerative joint disease.
  • Arthritis urica – joint inflammation based on a disorder of uric acid metabolism.
  • Osteoarthritis – degenerative joint disease.
  • Bouchard’s arthrosis – non-inflammatory disease that falls within the clinical picture of polyarthrosis (osteoarthritis); is often accompanied by Heberden’s arthrosis, but unlike the latter affects the finger medial joints.
  • Brucella arthritis – joint inflammation after infection with the bacterium Brucella.
  • Caplan syndrome (synonyms: silicoarthritis Caplan-Collinet syndrome, silicoarthritis or rheumatoid pneumoconiosis) – rare combination of silica dust lung (silicosis) and symptoms of chronic polyarthritis referred. Affected are mainly workers in the coal industry.
  • Felty syndrome – Severe course of rheumatoid arthritis, almost always rheumatoid factor-positive, occurring mainly in men between the ages of 20 and 40. Associated with hepatosplenomegaly (enlargement of the liver and spleen), leukocytopenia (decrease in the number of white blood cells/leukocytes) and thrombocytopenia (decrease in the number of platelets/platelets). Felty’s syndrome usually occurs after a prolonged course of chronic polyarthritis.
  • Fibromyalgia syndrome (soft tissue symptoms) – widespread syndrome leading to pain throughout the musculoskeletal system and additionally characterized by stiffness, sensory disturbances, sleep disturbances and chronic fatigue.
  • Heberden’s arthritis – idiopathic osteoarthritis of the distal interphalangeal joints (finger end joints) with formation of Heberden’s nodes (bicuspid, cartilaginous-bony growths on the extensor side of the base of the finger end links).
  • Infectious arthritis – spontaneously occurring acute arthritis; at 60 percent, staphylococci are the most common causative agent of infectious arthritis
  • Juvenile idiopathic arthritis (JIA; synonyms: juvenile rheumatoid arthritis (JRA), juvenile chronic arthritis, JCA) – rheumatoid arthritis of adolescent age.
  • Late onset rheumatoid arthritis – arthritis that does not occur until later in life (after age 60)
  • Lupus erythematosus – systemic autoimmune disease from the group of collagenoses.
  • Malignant rheumatoid arthritis – severe form of rheumatoid arthritis with rapid joint destruction.
  • Bekhterev’s disease (ankylosing spondylitis; Latinized Greek: spondylitis “inflammation of the vertebrae” and ankylosans “stiffening”) – chronic inflammatory rheumatic disease with pain and stiffening of joints.
  • Behçet’s disease (synonym: Adamantiades-Behçet’s disease; Behçet’s disease; Behçet’s aphthae) – multisystem disease of the rheumatic type associated with recurrent, chronic vasculitis (vascular inflammation) of the small and large arteries and mucosal inflammation; The triad (the occurrence of three symptoms) of aphthae (painful, erosive mucosal lesions) in the mouth and aphthous genital ulcers (ulcers in the genital region), as well as uveitis (inflammation of the middle eye skin, which consists of the choroid (choroid), the ray body (corpus ciliare) and the iris) is stated as typical for the disease; a defect in cellular immunity is suspected
  • Psoriatic arthritis – accompanying joint inflammation in psoriasis.
  • Reactive arthritis (synonym: post-infectious arthritis / joint inflammation) – secondary disease after gastrointestinal (gastrointestinal tract concerning), urogenital (urinary and genital organs concerning) or pulmonary (lungs concerning) infections; refers to an arthritis, where pathogens in the joint (usually) can not be found (sterile synovialitis).
  • Reiter’s disease (synonyms: Reiter’s syndrome; Reiter’s disease; arthritis dysenterica; polyarthritis enterica; postenteritic arthritis; posturethritic arthritis; undifferentiated oligoarthritis; urethro-oculo-synovial syndrome; Fiessinger-Leroy syndrome; English Sexually acquired reactive arthritis (SARA)) – special form of a “reactive arthritis” (see above. ); secondary disease after gastrointestinal or urogenital infections, characterized by the symptoms of Reiter’s triad; seronegative spondyloarthropathy, which is triggered especially in HLA-B27 positive persons by an intestinal or urinary tract disease with bacteria (mostly chlamydia); Can manifest as arthritis (joint inflammation), conjunctivitis (conjunctivitis), urethritis (urethritis) and partly with typical skin changes.
  • Rheumatoid arthritis (chronic polyarthritis) – most common inflammatory disease of the joints.
  • Rhizarthrosis – arthritis of the thumb saddle joint.
  • Ross River virus polyarthritis – joint inflammation affecting multiple joints due to a viral infection with the Ross River virus.
  • Sharp syndrome – chronic inflammatory connective tissue disease that includes symptoms of several collagenoses such as lupus erythematosus, scleroderma, or polymyositis
  • Still’s syndrome (synonym: Still’s disease): systemic form of juvenile rheumatoid arthritis occurring in children with hepatosplenomegaly (enlargement of the liver and spleen), fever (≥ 39 °C, over 14 days), generalized lymphadenopathy (enlargement of the lymph nodes), carditis (inflammation of the heart), transient exanthema (skin rash), anemia (anemia). The prognosis of this disease is unfavorable. Note: sharp increase in inflammatory parameters BSG (blood sedimentation rate) and CRP (c-reactive protein), leukocytosis (increase in the number of white blood cells; the number can reach such high values that one initially also thinks of the possibility of leukemia (so-called leukemoid reaction).
  • Systemic lupus erythematosus SLE) – systemic disease affecting the skin and connective tissue of the vessels, leading to vasculitides (vascular inflammation) of numerous organs such as the heart, kidneys or brain.

Neoplasms – tumor diseases (C00-D48).

  • Paraneoplastic arthritic complaints in cancer.

Psyche – nervous system (F00-F99; G00-G99).

  • Idiopathic carpal tunnel syndrome – nerve compression syndrome of the median nerve, that is, on the inside of the wrist, the nerve supplying the hand is constricted by connective tissue structures as it passes through the carpal canal; affects mainly postmenopausal women; symptoms: paresthesias (numbness), pain, and loss of grip strength.

Injuries, poisonings, and other sequelae of external causes (S00-T98).

  • Trauma (injuries)

Further

  • Chronic overload of the affected joints