People with degenerative types of arthritis, such as osteoarthritis and rheumatoid arthritis, typically experience a gradual onset of joint pain and stiffness. Acute forms of arthritis, however, develop suddenly. The rapid onset of joint-related symptoms proves a distinguishing characteristic of these arthritic illnesses. The various forms of sudden-onset arthritis frequently involve an infectious process.
Gout and Pseudogout
Gout is a common cause of acute arthritis caused by the deposition of urate crystals in the joint -- most commonly the one at the base of the big toe. Severe pain comes on suddenly, and the affected joint is swollen, red and tender. Symptoms last for days to weeks, with a tendency to persist longer with each gout attack.
A related but less common condition is pseudogout, now known as CPPD deposition disease. Symptoms are similar to gout but the type of crystal deposited into the joint space is calcium pyrophosphate dihydrate -- or CPPD -- instead of urate. As with gout, recurrent attacks are common.
Acute Septic Arthritis
Acute septic arthritis is an infection of a joint, usually caused by bacteria. Infecting bacteria may enter the joint directly through a traumatic injury or surgery. Alternatively, a bacterial infection at another body site may spread to a joint through the bloodstream. Acute septic arthritis affects a single joint in approximately 80 percent of cases. The joints most commonly affected include the knees, hips and shoulders.
Acute septic arthritis typically presents with the sudden onset of severe pain in the affected joint, which intensifies with movement. The area swells, reddens and feels warm to the touch. Other possible symptoms include fever and a generalized feeling of illness, or malaise. People with systemic lupus erythematosus, rheumatoid arthritis, sickle cell disease, hemophilia, cancer, diabetes and those with a weakened immune system prove at increased risk for acute septic arthritis.
Reactive arthritis, also known as Reiter syndrome, is an acute form of arthritis triggered by an infection elsewhere in the body. The condition most commonly arises in conjunction with a genital infection caused by Chlamydia trachomatis or an intestinal infection caused by campylobacter, yersinia, salmonella or shigella bacteria.
Arthritic symptoms associated with Reiter syndrome typically present approximately 2 to 6 weeks after the bacterial infection. Reactive arthritis can affect one or several joints, commonly involving the knees, ankles and feet. Pain ranges from mild to severe. Inflammation of one or more tendons also proves common with Reiter syndrome. Eye inflammation and skin rashes or ulcers may occur. Acute reactive arthritis develops more commonly in men than in women.
Lyme disease -- a bacterial infection cause by a bite from an infected tick -- may lead to sudden, episodic bouts of arthritic joint pain if the illness becomes chronic. Pain episodes commonly involve the knees or other large joints of the body. The arthritic episodes generally prove brief and usually do not cause permanent joint damage. The arthritis characteristically migrates, that is, it moves from one joint to another with each pain episode. In some people, arthritis symptoms persist after completion of antibiotic therapy.
Seek Medical Care
It's important to seek medical care right away if you develop sudden joint pain, especially if you have a fever or other symptoms along with the pain. Early diagnosis and treatment is often important to prevent long-term joint damage and reduce the likelihood of complications.
Is This an Emergency?
- The Merck Manual Professional Edition: Acute Infectious Arthritis
- The Merck Manual Professional Edition: Reactive Arthritis
- Clinical Primer of Rheumatology; William J. Koopman
- Todar's Online Textbook of Bacteriology: Borrelia Burgdorferi and Lyme Disease
- The Merck Manual Professional Edition: Gout
- UW Medicine, Orthopedics and Sports Medicine: CPPD Deposition Disease