Manifestations articulaires des parasitoses

Parasitic diseases are frequent, especially in tropical climatic contexts, but they are rarely associated with rheumatologic manifestations. These may happen, however, although some are discussed. Joint symptoms of parasitic diseases can be related either to the presence of the parasite inside the paw, or to a reactive inflammation probably from an immuno-allergic mechanism, with the parasite, in such condition, far from the paw. In the latter case, the fact that the parasite is the real cause is difficult to confirm, which explains that this entity, usually called parasitic rheumatism or reactive arthritis remains controversial. The clinical symptomatology is diverse, more often of mono-arthritis or oligo-arthritis type. It affects mainly the large articulations of the lower limbs, especially the knee, mimicking a beginning of spondylarthropathy. Small articulations can also be affected, presenting like a rheumatoid arthritis at the initial stage. In case of joint disease without obvious aetiology, possible parasitic origin should be evoked and specific favourable factors of exposure should be sought. As a matter of facts, specific anti-parasitic treatment may be efficient.