Overview of viral arthritis
Symmetrical polyarthritis is a well-recognised manifestation of infection with the following viruses:
- alphaviruses (Ross River virus, Barmah Forest virus, and chikungunya virus)
- flaviviruses (dengue virus, Zika virus, and yellow fever virus)
- parvovirus B19
- rubella virus (and its vaccine, which is an attenuated form of the virus)
- hepatitis B and C viruses
- human immunodeficiency virus (HIV).
Herpesviruses (eg Epstein–Barr virus, cytomegalovirus, varicella zoster virus), adenovirus and enterovirus can also cause arthritis, but this occurs less frequently because these viruses have a low predilection for the joints.
Both children and adults can be affected, with the prevalence of disease relating to the frequency of viral encounters.
Diagnosis is largely based on clinical assessment. Investigations are usually not required unless there is uncertainty about the diagnosis at presentation or the patient has persisting symptoms.
Most cases are self-limiting and do not require specific treatment or specialist referral. Management is focused on patient reassurance and symptomatic relief.