What Is Migratory Arthritis?

Migratory arthritis describes a pattern of arthritis symptoms and joint involvement. It is not a type of arthritis, per se, but the migratory pattern provides a clue to the diagnostician regarding what type of arthritis is involved and helps predict the disease course.

Migratory joint pain
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What Is Migratory Arthritis?

Simply put, migratory arthritis describes the condition when arthritis symptoms (e.g., pain, swelling, warmth, redness, and stiffness in or around a joint) travel from one joint to another joint.

Characteristically, when there is a migratory pattern, one or more joints are affected for a period of time, followed by a period of remission in those joints, as the symptoms re-appear in other joints (usually asymmetric joints). Usually, the onset of migratory arthritis is rapid.

The migratory pattern differs from an intermittent pattern, which is best described as a flare of symptoms followed by complete remission. In other words, in an intermittent pattern, symptoms are present for a limited period of time and then resolve.

The migratory pattern also differs from the additive pattern, whereby a few joints are involved initially but over time more joints are affected.

Associated Conditions

With regard to the migratory pattern, it is often related to an underlying medical condition. Here are some examples of conditions that may be associated with a migratory pattern of arthritis.

Infectious Arthritis

Infectious arthritis is caused by a germ (bacterium, virus, or fungus) that travels through the body to a joint. The germ can enter through the skin, nose, throat, ears, or an open wound. Infectious arthritis can also develop after an existing infection travels through the body to a joint.

Gonococcal Arthritis

Gonococcal arthritis is caused by infection of a joint. This type of arthritis can develop in people who have gonorrhea, which is caused by a specific bacteria, Neisseria gonorrhoeae.

Rheumatic Fever

Rheumatic fever is an inflammatory disease that may affect the heart, joints, brain, and skin that develops as a complication of infection with group A streptococcus. Usually, the streptococcus infection is located in the upper respiratory tract, such as strep throat, or as scarlet fever.

This photo contains content that some people may find graphic or disturbing.

erythema marginatum rheumatic fever
Erythema marginatum rash caused by rheumatic fever.

DermNet / CC BY-NC-ND

Reactive Arthritis

Reactive arthritis, an acute spondyloarthropathy, is a type of arthritis that occurs as a reaction to an infection elsewhere in the body. Aside from joint involvement, reactive arthritis is associated with redness and inflammation of the eyes and inflammation of the urinary tract.

Systemic Lupus Erythematosus

Systemic lupus erythematosus (SLE) is a chronic, inflammatory, autoimmune disease. Lupus can affect the joints, skin, kidneys, lungs, heart, nervous system, and other organs. Lupus can mimic other types of arthritis and rheumatic diseases, making the disease difficult to diagnose.

This photo contains content that some people may find graphic or disturbing.

systemic lupus erythematosus
SLE rash.

DermNet / CC BY-NC-ND

Inflammatory Bowel Disease (IBD)

Ulcerative colitis and Crohn's disease, chronic diseases of the intestinal tract, are often grouped together as inflammatory bowel disease because they share similar symptoms, although they differ in how they affect the digestive tract. Arthritis is the most common extra-intestinal complication associated with IBD.

Sarcoidosis

Sarcoidosis is a disease that can occur throughout the body, but most commonly affects the lungs, lymph nodes, or skin. With sarcoidosis, inflammation causes lumps, or granulomas, to form in the body's tissues. Granulomas, as they grow and clump, can affect how an organ works.

This photo contains content that some people may find graphic or disturbing.

sarcoidosis on face
Sarcoidosis on facial skin.

DermNet / CC BY-NC-ND

Lyme Disease

Lyme disease is an infectious disease caused by Borrelia burgdorferi, a bacterium that is classified as a spirochete. Borrelia burgdorferi lives inside of deer ticks and can be spread to humans by the bite of an infected tick.

With the early disseminated stage of Lyme disease, the infection spreads to the rest of the body in the weeks following the tick bite and may cause multiple problems, including joint pain. Late-stage infection, which may be months or years after onset, can lead to chronic arthritis.

This photo contains content that some people may find graphic or disturbing.

erythema migrans rash on chest
Lyme disease rash.

DermNet / CC BY-NC-ND

Bacterial Endocarditis

Endocarditis, or infective endocarditis, is an inflammation of the inner lining of the heart. The most common type, bacterial endocarditis, occurs when germs enter your heart. The germs travel through your bloodstream from another part of your body.

Bacterial endocarditis can damage your heart valves. Chronic infectious endocarditis may be associated with a variety of symptoms, including joint pain.

Whipple's Disease

Whipple's disease is a rare condition that prevents the small intestines from allowing nutrients to pass into the rest of the body (malabsorption). Whipple's disease is caused by infection with a specific bacteria, Tropheryma whippelii. The most common early symptom associated with Whipple's disease is joint pain.

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Article Sources
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  1. Merck Manual Professional Version. Acute infectious arthritis. Updated January 2019.

  2. Merck Manual Professional Version. Gonorrhea. Updated July 2019.

  3. National Organization of Rare Disorders. Rheumatic fever.

  4. American College of Rheumatology. Reactive arthritis. Updated March 2019.

  5. U.S. National Library of Medicine: Genetics Home Reference. Systemic lupus erythematosus. Updated November 26, 2019.

  6. Crohn's and Colitis Foundation. Arthritis. Updated 2020.

  7. National Center for Advancing Translational Sciences: Genetic and Rare Diseases Information Center. Sarcoidosis. Updated April 16, 2017.

  8. MedlinePlus. Lyme disease.

  9. Vilcant V, Hai O. Bacterial endocarditis. StatPearls. Updated August 10, 2020.

  10. National Institute of Neurological Disorders and Stroke. Whipple's disease. Updated 2019.