Which description best characterizes non-inflammatory arthritis?

• A. Pain worse at night; No soft tissue swelling; Cold joints; Morning stiffness <30 minutes; No systemic signs; Synovial fluid WBCs <2000
• B. Pain worse in the morning; Soft tissue swelling and warmth; Morning stiffness >1 hour
• C. Fever and systemic signs with high CRP
• D. Increased joint swelling with high ESR

Answer: (A)

Non-inflammatory arthritis, such as osteoarthritis, tends to cause pain with use and minimal signs of inflammation. The joints are often not warm or swollen, and morning stiffness is brief (usually less than 30 minutes). The absence of systemic symptoms is typical, and if you analyze the joint fluid, the white cell count is low (generally under 2000 cells/µL), reflecting a non-inflammatory process rather than an inflammatory one. The description in this item matches those patterns: pain that can be worse at night or with activity, no soft tissue swelling, cold joints, brief morning stiffness, no systemic signs, and a low synovial fluid white cell count. Inflammatory arthritis, by contrast, would show morning stiffness lasting over an hour, joint warmth and swelling, possible fever or systemic signs, and higher inflammatory markers or higher white cell counts in synovial fluid.