What Could Be the Cause of a Warm or Hot Joint?

Among the warning signs of arthritis

Woman touching warm, red ankle.
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Early warning signs of arthritis may include joint pain, joint stiffness, joint swelling, and warmth. A warm or hot joint really refers to a joint that is warm to the touch. There are several conditions related to a warm joint, some of which are serious. You should consult with your doctor for an accurate diagnosis. What are the possibilities?

Generally-speaking, warmth is indicative of active inflammation. There are several conditions that may be associated with a warm joint, including:

Diagnosing a Warm Joint

To distinguish between these conditions, your doctor will perform a physical examination. Along with a warm joint, your doctor will examine your joints for signs of swelling, redness, and tenderness. If there is redness, along with warmth, your doctor may suspect septic arthritis or gout. Swelling is typically indicative of active inflammation or joint effusion. If tenderness is localized, it could point to bursitis or muscle injury. The range of motion will be assessed passively (your doctor moves the affected joint) and actively (you move your own joint). Septic arthritis is associated with a significantly reduced range of motion, often occurring suddenly. The examination may reveal other visible signs of disease, such as rheumatoid nodules or gout tophi. A rash, called erythema migrans, often accompanies Lyme disease and is its primary characteristic. This rash can precede arthritis by months or years.

Your doctor will also take note of whether a single joint is affected or multiple joints. When a single joint is affected, called monoarthritis, septic arthritis and gout are typically suspected. When more than one joint is affected, reactive arthritis and rheumatoid arthritis are chief suspects.

While all of the visible signs gathered during the physical examination are significant and help to formulate a diagnosis, your doctor will likely need to perform a joint aspiration to obtain more information. The joint fluid is tested in a laboratory. The appearance of the joint fluid, microscopic examination (looking for crystals and bacteria), and chemical analysis can be revealing.

Other laboratory tests may be ordered too, such as a complete blood count, sedimentation rate, CRP, uric acid, rheumatoid factor. Along with the aforementioned blood tests, your doctor may request imaging studies of the affected joint, such as x-ray, MRI, CT scan, or ultrasound.

Treatment of a Warm Joint

While a warm joint is not an uncommon finding, the cause must be pinned down to rule out serious conditions. Septic arthritis, the most serious cause of a warm or hot joint and of greatest concern, is associated with a mortality of up to 11%. One-third of septic arthritis patients develop permanent joint damage. Following a joint aspiration and identification of the infectious agent, antibiotic therapy is critical for successful treatment of septic arthritis. If an infected joint replacement is involved, an orthopedic surgeon must be consulted. There is no time to waste when determining the cause of a warm joint and even less time to waste when the cause is an infection.

The Bottom Line

Accurate diagnosis and appropriate treatment for a warm joint are essential. A warm joint should not be ignored, especially if it has come on suddenly and has significantly affected the range of motion or your ability to put weight on it.

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