David Gryfe1, Calvin Wong2. 1. Private Practice, Etobicoke, ON. 2. Graduate Student, Sports Sciences RCCSS (C).
Abstract
OBJECTIVE: To review the epidemiology, etiology, diagnosis and typical management of erythema infectiosum and to illustrate the clinical management of an adult with erythema infectiosum. CLINICAL FEATURES: A 38-year-old male complaining of severe global pain, swelling, weakness and stiffness in his shoulders, elbows, knees, and fingers of seven weeks duration. INTERVENTION AND OUTCOME: The patient was treated with a combination of 1) pharmacological treatment of naprosyn, prednisone, methotrexate, hydroquinone and sulfasalazine, 2) conservative treatment consisting of spinal manipulation, peripheral joint mobilization, acupuncture and low-tech Qi Gong and Tai Chi exercises, and 3) an active physiotherapy program consisting of strengthening exercises, and stationary bike. The patient reported marked improvement in pain, mobility, strength, and function with the addition of conservative physical treatment. SUMMARY: Erythema infectiosum is associated with a wide spectrum of clinical manifestations, where arthropathy is the most common clinical manifestation in adults. Erythema infectiosum should be suspected as a potential differential diagnosis when a patient presents with red or purplish skin rashes, especially when accompanied by fever and joint pain. Conservative management could be considered as an adjunctive therapy option for this condition. However, further validation and research is warranted.
OBJECTIVE: To review the epidemiology, etiology, diagnosis and typical management of erythema infectiosum and to illustrate the clinical management of an adult with erythema infectiosum. CLINICAL FEATURES: A 38-year-old male complaining of severe global pain, swelling, weakness and stiffness in his shoulders, elbows, knees, and fingers of seven weeks duration. INTERVENTION AND OUTCOME: The patient was treated with a combination of 1) pharmacological treatment of naprosyn, prednisone, methotrexate, hydroquinone and sulfasalazine, 2) conservative treatment consisting of spinal manipulation, peripheral joint mobilization, acupuncture and low-tech Qi Gong and Tai Chi exercises, and 3) an active physiotherapy program consisting of strengthening exercises, and stationary bike. The patient reported marked improvement in pain, mobility, strength, and function with the addition of conservative physical treatment. SUMMARY: Erythema infectiosum is associated with a wide spectrum of clinical manifestations, where arthropathy is the most common clinical manifestation in adults. Erythema infectiosum should be suspected as a potential differential diagnosis when a patient presents with red or purplish skin rashes, especially when accompanied by fever and joint pain. Conservative management could be considered as an adjunctive therapy option for this condition. However, further validation and research is warranted.