What are the characteristic temporal patterns of joint involvement in polyarthritis
a) Migratory pattern: Symptoms are present in certain joints for a few days and then remit, only to reappear in other joints. Rheumatic fever, early gonococcal arthritis, early Lyme disease, Whipple’s disease, and acute childhood leukemia are examples.
b) Additive pattern: Symptoms begin in some joints and persist, with subsequent involvement of other joints. This pattern is common in RA, SLE, and other polyarticular syndromes.
c) Intermittent pattern: This pattern is typified by repetitive attacks of acute polyarthritis with remission between attacks. A prolonged observation may be necessary to establish this phenomenon. Crystalline arthropathy is the most common category causing this pattern of arthritis. Psoriatic arthritis, reactive arthritis, palindromic rheumatism, familial Mediterranean fever, and Whipple’s disease may present in this manner as well. RA, remitting seronegative symmetrical synovitis with pitting edema, SLE, sarcoidosis, and Still’s disease can also present episodically early in their disease course.