15 year old boy presents with multiple joint swelling and tenderness for 1 week....the patient currently unable to mobilise.. there is history of on/off joint paints but this event is e worst of all.. patient was born with a missing limb..stays in rural areas...no money for investigations..patient is hiv positive on ART...differentials?

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Acute polyarthritis has a very wide differential diagnosis, presenting significant diagnostic difficulties. Where oligoarthritis (<5 joints affected) is the presenting feature, some of the causes of acute monoarthritis must be considered, of which the most important not to miss is septic arthritis (particularly that due to gonococcal infection which may affect several joints). Inflammatory :- Juvenile idiopathic arthritis. Inflammatory bowel disease. Sarcoidosis. Primary malignancy - haematological (acute lymphoblastic leukaemia). Neuroblastoma. Fibromyalgia. Infection :- Septic arthritis. Osteomyelitis. Tuberculosis. Human immunodeficiency virus - THIS BOY IS HIV POSITIVE. Reactive arthritis :- Post-streptococcal infection. Rheumatic fever. Post-enteric illness. Lyme arthritis. Systemic disease :- Systemic lupus erythematosus (SLE). Kawasaki disease. Systemic sclerosis. Henoch-Schönlein purpura. Mechanical :- Trauma. Inherited skeletal dysplasias. Hypermobility. Avascular necrosis. Growing pains. Metabolic :- Rickets. Thyroid disease. Diabetes. Tumours :- Primary of cartilage or bone (benign or malignant). Unknown :- Reflex sympathetic dystrophy. JUVENILE CHRONIC ARTHRITIS is the most common arthritis in children. Family history may be present in cases of rheumatoid arthritis (RA), seronegative arthropathies and osteoarthritis. Pain is not often discriminatory in diagnostic terms. Speed of onset may help - gout tends to come on abruptly, whereas RA is usually more gradual. Similarly, GOUT tends to cause very severe, excruciating pain. DRUGS ASSOCIATED WITH POLYARTHRALGIA.

RHEUMATOLOGICAL MANIFESTATION OF HIV itself is an ocean. Any form of joint involvement is possible. >50% of those PLHA (people living with HIV/AIDS) ll have some forms of rheumatological involvement. in that HIV related arthritis, reactive arthritis are more common. Most often to continue HAART and symptomatic management s enough.

15 years patient, born with missing limb, HIV POSITIVE, & ON ART. HIV POSITIVE, WITH MULTIPLE JOINT SWELLINGS ONE HAS TO R/O TUBERCULOUS JOINT INVOLVEMENT. D/D : REACTIVE ARTHRITIS. SEPTIC ARTHRITIS.

Astonishing case 15 yrs s/f phocomelia and hiv Joint involvement is mostly becoz of HIV arthopathy or reactive arthropathy. Even it can be autoimmune arthritis

Rheumatoid arthritis

HIV arthropathy Septic/tuberculous arrthropathy

Some superinfection arthritis

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