Viral arthritis – A number of viral diseases ranging from Rubella, Hepatitis B, Chikungunya to mumps, entero virususes and adenovimses may produce a mild form of arthritis without any destructive changes in the joint.
In rubella, arthritis which involves primarily small joints of the hands and wrist follows a few days after the appearance of the rash. It may also follow after 2 weeks of vaccination.
The joints are bilaterally symmetrically involved with pain stiffness and swelling. Young women are more likely to develop this type of arthritis in the course of rubella infection.
Treatment of Viral arthritis is symptomatic and in most cases recovery takes place spontaneously. In a few cases, the disease is persistent or recurrent even lasting up to months to a year.
Arthritis in hepatitis B is seen in the prodromal stage of the disease. There is symmetric involvement of the small joints associated with morning stiffness. There is synovitis associated with urticarial rash which may be erythematous or maculopapular. This arthritis usually resolves as it is immunologically mediated.
Besides the above viral arthritis may occur in mumps. Coxsackie and adenoviral infections. Chikungunya is another important cause. The arthritis is generally polyarticular associated with fever and rash.
The joints are swollen with periarticular soft tissue swelling. Transient polyarthritis may also be seen in chicken pox and infectious mononucleosis. This is self limiting and generally responds to salicylates.