Viral Arthritis

A virus can affect a joint in two ways. A virus can directly infect a joint by invading its inside lining, called the synovium. The virus can also cause a bodywide immune system response, which can cause joint swelling and pain. In this case, the joint is attacked by the immune system, rather than the virus.

Symptoms of viral arthritis include joint pain, stiffness, and swelling. Specific symptoms depend on the type of virus causing the infection. For example, someone with hepatitis B may develop abdominal distress, nausea, and jaundice, which is a yellowish discoloration of the eyes and skin.

Common causes of viral arthritis include:

• German measles, which is an infection caused by the rubella virus
• HIV, the virus that causes AIDS
• infection with with Hepatitis B and Hepatitis C
• infection with human parvovirus, which causes fifth disease
• mumps
• some vaccinations, such as the MMR immunization

Other causes are also possible, though less common.

There is little that can be done to prevent viral arthritis, except to avoid exposure to viruses when possible. Immunizations are available against rubella, mumps, and hepatitis B. However, the rubella vaccine can actually cause this condition, since it contains a live, weakened form of the virus.

A person with viral arthritis will complain of joint swelling that occurs shortly after an infection caused by a virus. Or a person may have joint symptoms after getting a vaccine against a virus. Blood tests for these viruses can often confirm that the joint swelling and pain are caused by the infection.

Chronic inflammation of the joint lining, known as synovitis, can develop in people who have chronic active hepatitis. In other cases, the arthritis tends to resolve on its own, but this process may take months or even years.

Other long-term effects are related to the underlying cause. For example, long-term Hepatitis B infection can result in serious liver damage, liver cancer, or even death in some cases.

The viruses that can cause viral arthritis are contagious and may be passed to others. The viral arthritis itself is not contagious.

Treatment usually includes aspirin, NSAIDs (nonsteroidal anti-inflammatory drugs) such as ibuprofen (i.e., Advil, Motrin) or naproxen (i.e. Aleve, Anaprox, Naprosyn) or other pain medications to help with the joint pain and inflammation. This is all the treatment most people need.

If pain is severe in a particular joint, a joint fluid aspiration may be done. A needle is inserted into the joint to withdraw some of the joint fluid.

Immunoglobulins may also rarely be given.

Aspirin or other NSAIDs may cause an allergic reaction, stomach irritation, or bleeding. Other specific side effects depend on the pain medication used.

A person may have joint swelling and pain that lasts for a long time, although this is rare. Once a person feels better, no further treatment is usually needed.

A healthcare provider will follow up with a person until the symptoms go away. Further monitoring may be needed for the underlying infection. Any new or worsening symptoms should be reported to the healthcare provider.