An Overview of Inflammatory Polyarthritis

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Polyarthritis is also known as polyarticular arthritis or inflammatory polyarthritis. It is defined as arthritis or joint pain that simultaneously affects five or more joints.

The term describes the number of joints involved: poly means many. Polyarthritis may be chronic or transient (temporary).

Polyarthritis is most often associated with autoimmune diseases such as rheumatoid arthritis (RA), and certain viral infections can also trigger it.

This article explains polyarthritis symptoms, causes, diagnosis, and treatment.

Arthritic hand indicative of polyarthritis

Mike Devlin / Science Photo Library / Getty Images

Symptoms

Polyarthritis symptoms tend to be similar to those of rheumatoid arthritis and other autoimmune diseases that affect the joints. They can develop suddenly or over many months.

Signs of joint inflammation

Signs of joint inflammation typically include swelling, warmth, pain, and decreased range of motion.

Morning stiffness and pain that improves with activity and worsens with rest are classic symptoms of inflammatory arthritis.

Autoimmune diseases tend to trigger an all-body response because they're systemic diseases with varied symptoms. Therefore, joint involvement generally does not appear in isolation as it might with osteoarthritis (OA). Instead, there are many other symptoms, like a rash.

Other symptoms include:

  • Lack of appetite
  • Rash
  • Sweating
  • Swollen lymph nodes
  • Temperature of 100.4 degrees or above
  • Tiredness or a lack of energy
  • Unexpected weight loss

In rare cases, the inflammatory disease that causes polyarthritis can also cause scarring in the lungs, dry eyes, skin rash, and pericarditis (inflammation in the sac surrounding the heart).

Polyarthritis, which is inflammation of multiple joints, is different than polyarthralgia, which is pain of multiple joints without associated joint inflammation, such as what happens in OA, a wear and tear type of arthritis.

Causes

Polyarthritis may be caused by an autoimmune disorder or an acute illness. It occurs when the inflammation affects joints in the body. Symptoms can be constant or may flare up as the underlying inflammatory condition flares up.

Autoimmune Disorders

Polyarthritis is most often caused by autoimmune disorders. In autoimmune disorders, the immune system mistakenly attacks its cells and tissues. The causes of autoimmune diseases are not well understood but are strongly associated with genetics and the environment.

The autoimmune disorders most commonly associated with polyarthritis include:

Illness

Polyarthritis can also occur as part of an acute illness such as:

In these cases, the inflammation may move between multiple joints.

Diagnosis

Polyarthritis is most commonly associated with an underlying disease, so your healthcare provider will typically start with an evaluation to see if you have a systemic disorder. Inflamed joints, tenderness, joint effusion (known as water on the knee), and swelling are common signs of autoimmune diseases.

Symmetry vs. Asymmetry

Your healthcare provider will evaluate whether your pain is symmetric (symptoms are occurring in both hands or knees, for example) or asymmetric (just the joints on one side are symptomatic). People with RA tend to experience symmetric symptoms. Those with psoriatic arthritis often experience asymmetric symptoms.

Blood Tests

Bloodwork may be necessary to help narrow down a diagnosis. Tests to screen for RA commonly include:

In addition, your healthcare provider may check your blood for:

  • Anemia
  • Elevated white blood cell count
  • Elevated platelets
  • Increased inflammatory markers, known as erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP)

Serology testing may also be helpful to look for antibodies related to specific autoimmune diseases. Your healthcare provider will also test for viruses if an infectious cause is suspected.

Imaging Tests

Depending on the suspected cause, X-rays, a musculoskeletal ultrasound, magnetic resonance imaging (MRI), and a joint fluid analysis (also known as arthrocentesis) may be helpful.

Treatment

Treatments for polyarthritis are typically the same as for autoimmune diseases. They include medications for pain and inflammation, drugs to inhibit disease progression, and at-home therapies.

Medication

Non-steroidal anti-inflammatory drugs (NSAIDs) like Advil (ibuprofen), Aleve (naproxen), and Voltaren (diclofenac) can help relieve pain and stiffness.

In addition, disease-modifying anti-rheumatic drugs (DMARDs) can help slow the course of autoimmune diseases. For example, healthcare providers frequently prescribe methotrexate to reduce joint damage caused by polyarthritis.

Biologics, including Remicade (infliximab) and Enbrel (etanercept), modify the immune system to reduce inflammation.

Corticosteroids help control inflammation and reduce pain. You can take steroids orally or via injection. They should only be used in the short term, as they can cause serious side effects.

Treatment for viral-associated polyarthritis is typically symptom-based, as this condition tends to resolve without treatment.

At-home Therapies

Warming therapies can temporarily relieve symptoms.

These include:

  • Warm baths
  • Warming mitts
  • Over-the-counter (OTC) topical creams such as Aspercreme

In addition, don't underestimate the value of exercise in managing polyarthritis. Low-impact activities like swimming, yoga, and stretching, can help keep joints healthy.

Summary

Polyarthritis is a type of arthritis that affects five or more joints. Joint pain and inflammation are the most common symptoms, and symptoms may also include rash, fever, and fatigue. It is most commonly caused by an autoimmune disorder but can also be triggered by an acute infection. Treatment involves medication, at-home comfort measures, and exercise to keep joints flexible.

A Word From Verywell

It's essential to get a diagnosis and treatment for polyarthritis before the condition worsens and causes permanent joint damage. If you experience joint pain, call your healthcare provider.

Frequently Asked Questions

  • How is polyarthritis treated?

    Polyarthritis is treated similarly to arthritis and other autoimmune diseases. Potential treatments include disease-modifying anti-rheumatic drugs (DMARDs), non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroids, surgery, medications, massage, and covered heat packs.

  • What is migratory polyarthritis?

    Migratory polyarthritis refers to the gradual spread of arthritis to different joints. Arthritis will begin in one or two joints and appear to improve after several days, only to return and affect a different set of joints. It is considered acute polyarthritis when symptoms last fewer than six weeks and chronic if symptoms last longer.

  • How many people have JIA?

    In 2019, a total of 294,000 children had juvenile idiopathic arthritis (JIA) in the United States. Seven types of JIA show unique symptoms and can affect many joints. The exact cause is unknown.

5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Akhondi H, Gupta N. Polyarticular arthritis. National Center for Biotechnology Information, U.S. National Library of Medicine. PMID:30725855

  2. Pujalte G, Albano-Aluquin S. Differential diagnosis of polyarticular arthritis. Am Fam Physician. 2015; 92(1):35-41.

  3. Johns Hopkins Medicine. Arthritis.

  4. Alpay-Kanıtez N, Çelik S, Bes C. Polyarthritis and its differential diagnosisEur J Rheumatol. 2018;6(4):167-173. doi:10.5152/eurjrheum.2019.19145

  5. MedlinePlus. Juvenile Idiopathic Arthritis.

Additional Reading

By Carol Eustice
Carol Eustice is a writer covering arthritis and chronic illness, who herself has been diagnosed with both rheumatoid arthritis and osteoarthritis.