A child with acute monoarthritis needs urgent evaluation and treatment. A detailed history and examination should be done. In a well child, history of significant trauma should be obtained foremost, and fractures should be looked for in radiographs. However, a history of trauma does not exclude joint infection. After ruling out these conditions, other diagnosis such as bleeding disorders and Juvenile idiopathic arthritis(JIA) should be kept in mind. Morning stiffness is a characteristic feature of inflammatory arthritis.
In a sick child, it is essential to rule out septic arthritis. Joint fluid aspiration can be done and the fluid should be sent for blood cell count, Gram stain, and culture.
Other common causes of monoarthritis are Reactive arthritis, Tubercular arthritis, Transient Synovitis of Hip joint.
When in doubt, an expert pediatric rheumatologist opinion can be sought for.
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