Evaluation of seronegative arthritis

Last reviewed: 2 Jun 2025
Last updated: 24 Jun 2025

Summary

Differentials

Common

  • Axial spondyloarthritis (Ankylosing spondylitis [AS])
  • Psoriatic arthritis
  • Reactive arthritis
  • Undifferentiated spondyloarthropathy
  • Calcium pyrophosphate deposition disease (CPPD)
  • Gout
  • Polymyalgia rheumatica
  • Osteoarthritis (OA)
  • Rheumatoid arthritis (RA)
  • Systemic lupus erythematosus (SLE)
  • Septic arthritis
  • Bacterial endocarditis
  • Viral arthritis
Full details

Uncommon

  • Enteropathic arthritis
  • Remitting seronegative symmetrical synovitis with pitting edema syndrome
  • Sarcoidosis
  • Juvenile-onset or adult-onset idiopathic arthritis
  • Overlap syndrome
  • Sjogren syndrome
  • Scleroderma
  • Polymyositis
  • Dermatomyositis
  • Systemic vasculitis
  • Gonococcal arthritis
  • Rheumatic fever
  • Lyme disease
  • Whipple disease
  • Tuberculous arthritis
  • Paraneoplastic arthritis
  • Neoplastic carcinomatosis
Full details

Contributors

Authors

Gurjit S. Kaeley, MBBS, MRCP

Professor of Medicine

Chief, Division of Rheumatology and Clinical Immunology

Medical Director, Musculoskeletal Ultrasound Program

Program Director, Rheumatology Fellowship

University of Florida College of Medicine - Jacksonville

Jacksonville

FL

Disclosures

GSK declares that he has no competing interests.

Peer reviewers

Jacob Aelion, MD

Clinical Professor of Medicine

University of Tennessee Health Science Center

Memphis

TN

Disclosures

JA is a consultant and on the speakers' roster for Abbott, Amgen, Forrest, Roche, Takeda, UCB, Wyeth. JA has received research funding from NIH and the National Psoriasis Foundation.

William Taylor, PhD, MBChB, FAFRM, FRACP

Associate Professor; Head

Rehabilitation Teaching and Research Unit

Department of Medicine

University of Otago

Wellington

New Zealand

Disclosures

WT declares that he has no competing interests.

Rod Hughes, MA, MD, FRCP

Consultant Rheumatologist

Ashford and St Peter's Hospitals NHS Trust

Chertsey

Surrey

UK

Disclosures

RH declares that he has no competing interests.

References

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Key articles

Combe B, Landewe R, Daien CI, et al. 2016 update of the EULAR recommendations for the management of early arthritis. Ann Rheum Dis. 2017 Jun;76(6):948-59.Full text  Abstract

Sieper J, van der Heijde D, Landewé R, et al. New criteria for inflammatory back pain in patients with chronic back pain: a real patient exercise by experts from the Assessment of SpondyloArthritis International Society (ASAS). Ann Rheum Dis. 2009;68:784-8. Abstract

Expert Panel on Musculoskeletal Imaging, Subhas N, Wu F, et al. ACR appropriateness criteria® chronic extremity joint pain-suspected inflammatory arthritis, crystalline arthritis, or erosive osteoarthritis: 2022 update. J Am Coll Radiol. 2023 May;20(5s):S20-32. Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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