What You Should Know About Migratory Arthritis

x-ray showing joint pain
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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.

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 which may affect the heart, joints, brain, and skin. It 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.

Reactive Arthritis: Reactive arthritis, an acute spondylarthropathy, 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 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.

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.

Lyme Disease: Lyme disease is an infectious disease caused by Borrelia burgdorferi, a bacterium which 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.

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

  • Arthritis. Crohn's and Colitis Foundation of America. 
  • Kelley's Textbook of Rheumatology. Elsevier. Ninth edition. Chapter 42. Polyarticular Arthritis. Cush and Dao.
  • Migratory Arthritis. Merck Manual Professional Version. 
  • Whipple's Disease. MedlinePlus.