Viral infection as a cause of arthritis.

Rheumatic complaints secondary to viral infections are usually brief, self-limited and nondestructive. They may accompany almost any type of viral illness, and the arthritic presentation is nonspecific. These manifestations are protean, ranging from arthralgia to vasculitis. Often the cause of the rheumatic complaint remains elusive because of the prompt resolution of the viral infection. Evaluation for autoimmune diseases should be postponed until the symptoms have been present for at least six weeks. However, some viral diseases, such as parvovirus, chronic hepatitis B virus and hepatitis C virus infections, can produce long-lasting rheumatic symptoms. Since the arthritis associated with hepatitis C infection has only recently been recognized, it is important to search for this association in patients who have atypical rheumatic complaints, risk factors for hepatitis and alterations in liver enzymes, so that an accurate diagnosis can be established and the pathophysiology can be better understood.