What are the most likely diagnoses in hospitalized patients who develop acute monoarticular arthritis following admission for another medical or surgical disease?
Acute gout, pseudogout, and infection are by far the most common causes of acute monoarticular arthritis. These patients are often middle-aged or elderly, which is the primary age range for crystalline arthropathies. In addition, they often have hospitalization-related risk factors known to provoke gout or pseudogout attacks, for example, trauma, surgery, hemorrhage, infection, or medical stress such as renal failure, myocardial infarction, and stroke. Clinicians must be especially careful to exclude infection in such hospitalized patients.