In parvovirus B19–related arthritis, which pattern of joint involvement is most typical?

• A. Symmetric small-joint arthritis
• B. Asymmetric large-joint arthritis
• C. Monoarticular knee arthritis
• D. No arthritis

Answer: (A)

Parvovirus B19–related arthritis most often presents as a symmetric inflammatory arthritis of the small joints of the hands, especially the metacarpophalangeal and proximal interphalangeal joints, and can involve wrists as well. This bilateral, small-joint involvement reflects an immune-mediated synovitis that can occur after acute parvovirus infection in adults and often mimics rheumatoid arthritis. The pattern is typically acute and may be migratory, with arthritis that resolves over weeks to a few months, which helps distinguish it from chronic rheumatoid disease. In contrast, asymmetric involvement of large joints or a single knee joint suggests other conditions, and no arthritis would not fit the typical parvovirus presentation.