Mathew Ashish Jacob, Ravindran Vinod
Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India.
Centre for Rheumatology, Calicut, Kerala, India.
Best Pract Res Clin Rheumatol. 2014 Dec;28(6):935-59. doi: 10.1016/j.berh.2015.04.009. Epub 2015 May 27.
Bacteria, viruses, fungi, and parasites can all cause arthritis of either acute or chronic nature, which can be divided into infective/septic, reactive, or inflammatory. Considerable advances have occurred in diagnostic techniques in the recent decades resulting in better treatment outcomes in patients with infective arthritis. Detection of emerging arthritogenic viruses has changed the epidemiology of infection-related arthritis. The role of viruses in the pathogenesis of chronic inflammatory arthritides such as rheumatoid arthritis is increasingly being recognized. We discuss the various causative agents of infective arthritis and emphasize on the approach to each type of arthritis, highlighting the diagnostic tests, along with their statistical accuracy. Various investigations including newer methods such as nucleic acid amplification using polymerase chain reaction are discussed along with the pitfalls in interpreting the tests.
细菌、病毒、真菌和寄生虫均可引起急性或慢性关节炎，可分为感染性/脓毒性、反应性或炎症性。近几十年来，诊断技术取得了长足进步，使感染性关节炎患者的治疗效果更佳。新型致关节炎病毒的发现改变了感染相关关节炎的流行病学。病毒在类风湿关节炎等慢性炎症性关节炎发病机制中的作用日益受到认可。我们讨论了感染性关节炎的各种病原体，并强调了针对每种关节炎类型的处理方法，重点介绍了诊断测试及其统计准确性。还讨论了包括聚合酶链反应核酸扩增等新方法在内的各种检查以及解读检查结果时的陷阱。
