A case of acute parvoviral arthritis: JAMA
Now open: Certificate Course in Management of Covid-19 by Govt. Of Gujarat and PlexusMDKnow more...Now open: Certificate Course in Management of Covid-19 by Govt. Of Gujarat and PlexusMDKnow more...
A 58-year-old woman with a history of cervical spondylosis and hypothyroidism presented with a 2-week history of joint pain. She noted pain and swelling in her right knee, which migrated to the right ankle and then affected the metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints of her fingers.

About 2 weeks before her symptoms began, her 5-year-old grandson had a febrile illness characterized by headaches, body aches, malaise, and rash on the cheeks, trunk, and extremities but no arthritis. Ten days later, her 10-month-old granddaughter developed a similar febrile illness. Eight days ago, her 25-year-old daughter developed headaches, malaise, and significant arthralgias affecting her wrists and knees but no rash or fever. Manifestations in all of the family members resolved spontaneously within 1 week.

On examination, the patient was afebrile with normal vital signs. A malar rash was present, but there was no rash on the trunk or extremities. She had swelling and tenderness of the MCP and PIP joints and had difficulty making a fist and fully extending her fingers. Laboratory studies revealed a mild normochromic normocytic anemia with a hemoglobin level of 11.5 g/dL, normal white blood cell and platelet counts, and normal results for a comprehensive metabolic panel. She had a positive antinuclear antibody (ANA) result (1:160 [homogeneous pattern; negative <1:80 serum dilution]). Testing for rheumatoid factor was negative; levels of inflammatory markers were normal.

The patient was diagnosed with parvovirus-associated arthritis.

Major takeaway:-
- The key to the correct diagnosis in this patient is the history of recent exposure to children with a febrile illness associated with a facial rash (“slapped cheek”), suggestive of erythema infectiosum, also known as fifth disease.

- Diagnosis of recent parvovirus infection requires detection of parvovirus B19–specific IgM antibodies.

Read more here: https://jamanetwork.com/journals/jama/fullarticle/2719861
Dr. B●●●●●h K●●●r N●●●●●●●●m and 4 others like this1 share
Dr. H●●●●h A●●●●●●●●●r
Dr. H●●●●h A●●●●●●●●●r Orthopaedics
What was the line of treatment?
Dec 31, 2018Like
Dr. j●●●●h J●●●●●●●i
Dr. j●●●●h J●●●●●●●i General Medicine
Jan 1, 2019Like
V●●●●●v P●●●r
V●●●●●v P●●●r General Medicine
Jan 2, 2019Like