Version May 2024
| Diagnosis | Sex | Age | Lab tests | Comments |
| Undifferentiated inflammatory arthritis | F > M | 35 to 65 | 10 to 15% RF+ Less frequent ACPA+ | Chronic, usually seronegative, inflammatory arthritis, atypical of RA or fails to meet classification criteria for RA. Up to 50% may evolve into RA; up to 25% will go into remission. |
| Rheumatoid arthritis | F > M | 35 to 65 | 70 to 80% RF+ 70 to 80% ACPA+ | Chronic inflammatory polyarthritis, typically meets classification criteria for RA. RA often begins insidiously with vague constitutional and musculoskeletal symptoms that may last up to months before synovitis is evident. |
| Undifferentiated peripheral spondyloarthritis | M > F | 15 to 45 | > 50% HLA-B27+ | Most often presents as asymmetric large-joint involvement with predominantly lower-extremity involvement, and often with enthesitis or occasionally dactylitis, as in several forms of SpA. May involve only a few joints. Often "silent" urogenital tract infection (eg, chlamydia). |
| Psoriatic arthritis | M = F | 30 to 55 | <20% RF+ | Some patients have asymmetric large joint involvement, similar to other SpA. 50% of those with psoriatic arthritis will have an RA-like distribution (MCPs, PIPs, wrists). Cutaneous psoriasis will be evident in the vast majority of cases. |
| Tophaceous gout | M > F | M: 25 to 70 | Usually RF– | Intermittent inflammatory arthritis during the onset, with evolution of tophi and chronic inflammatory polyarthritis. Elevated serum urate and tophi help distinguish from RA. |
| F: >45 | >95% ↑ serum urate | |||
| Erosive inflammatory osteoarthritis | F > M | >60 | Usually RF– (but normally slight increase in RF-positivity with increasing age) | Chronic polyarthritis with intermittent or sustained inflammation affecting PIP and DIP joints. Radiographs demonstrate distinctive erosions and evidence of OA. |
| Pseudogout | F = M | >60 | Usually RF– (but normally slight increase in RF-positivity with increasing age) | 5% of patients will have "rheumatoid-like" inflammatory arthritis with stiffness, fatigue, synovitis, and elevated ESR, often lasting 4 weeks to several months. |
| Reactive arthritis (formerly known as Reiter syndrome) | M > F | 16 to 50 | Usually RF–; 50 to 80% HLA-B27+ | Post-infectious SpA; often associated with low back pain, ocular, genitourinary, or GI symptoms and enthesitis (heel pain). |
| Enteropathic arthritis | M = F | All ages | Usually RF– | Up to 20% of patients with Crohn disease or ulcerative colitis will develop peripheral arthritis. Diagnosis may be difficult until GI involvement becomes apparent. Associated with oral ulcerations, GI symptoms, or other features of SpA. |
| Systemic lupus erythematosus | F > M | 15 to 40 | 10 to 15% RF+; >95% ANA+ (>80% anti-dsDNA-positive; other characteristic ANA subsets) | Chronic non-deforming inflammatory polyarthritis associated with ANA positivity and other features of SLE. |
| Polymyositis/ dermatomyositis | F > M | 30 to 60 | 95% RF–; >50% ANA+ (characteristic ANA subsets); >70% ↑ CK | Chronic inflammatory arthritis uncommonly occurs early in course of PM/DM. Features of proximal muscle weakness, bulbar dysphagia, muscle enzyme elevation, or skin involvement (ie, Gottron papules) should be sought. |
| Scleroderma | F > M | 30 to 50 | 95% RF–; >90% ANA+ (characteristic ANA subsets) | Chronic inflammatory polyarthritis may predominate over skin changes early in the disease. Associated with Raynaud phenomenon, sclerodactyly, dysphagia, hypertension, or kidney abnormalities. |
| Sarcoid arthritis | F > M | 20 to 40 | Usually RF– | 15% of patients with sarcoidosis will develop arthritis. Early in the disease, a chronic inflammatory oligo- or polyarthritis lasting weeks to months may develop and typically involve the ankles and knees. Other features of sarcoidosis (ie, erythema nodosum, hilar adenopathy) are usually apparent. |
| Parvovirus B19-associated arthritis | F > M | Any age | <10% RF+; >80% anti-B19 IgM antibodies (acutely) | Adults manifest a flu-like picture and seldom develop the "slapped-cheek" rash; arthralgias are more common than arthritis. Arthritis is an acute inflammatory polyarthritis with an RA-like distribution mostly lasting approximately 2 weeks. Less than 10% develop a chronic inflammatory arthritis. |
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