Migratory Arthritis

Question

For the last 6 weeks I have been experiencing migratory joint pain. It started in the knuckle joints of my hands, moved to my jaw, hips and metatarsel joints. Each day it moves to one of these different areas. My hands and feet feel warm but there in no swelling or redness. I generally feel sick. My family doctor has been treating me for Lyme Disease for 5 weeks with Doxycycline 300 mg with no improvement in symptoms. I did not have the EM rash. All my lab test have come back negative- RF, ESR, ANA, Parvo, and Elisha. With these presenting symptoms what is your medical opinion?

Answer

My opinion isn’t worth much without seeing you and reviewing your symptoms. There are many possbilities including early RA or SLE. Rheumatic fever due to strep infections is classically the disease that causes a true migratory arthritis, but this is very rare in the modern day of antibiotics.

Alan Matsumoto, M.D.

About Alan Matsumoto, M.D.

Part-time Faculty, Division of Rheumatology
Johns Hopkins University