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Lupus arthritis
Best Practice & Research: Clinical Rheumatology, 07/28/09

Grossman JM – Patients with systemic lupus erythematosus (SLE) frequently suffer from an inflammatory arthritis, which typically manifests as a polyarticular arthritis, more likely to affect small joints and with less prominent synovitis than is seen in RA. This article addresses the clinical features of arthritis in lupus and an approach to the differential diagnosis. A variety of medications are effective in the treatment of lupus arthritis; however, identifying therapies that are more targeted to the joint symptoms and have fewer side effects and risks are long-term goals for lupus research.

• Inflammatory arthritis is present in 69–95% of pts with SLE
• While the arthritis is less inflammatory than is seen with RA, deforming arthritis can occur
• Avascular necrosis (AVN) is an important consideration in the differential diagnosis of joint pain in SLE
• Joint manifestations in SLE can often be managed with NSAIDs, anti-malarials and low-dose corticosteroids
• Therapy targeted to the treatment of joint manifestations in SLE is needed
• Also needed are the randomized controlled trials to determine the best approach for treatment of AVN in SLE

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