Arthritis is defined as an inflammation of a joint. This diagnostic code refers to arthritis that occurs secondary to typhoid; that is a focal form of a distributed infection caused by the organism, Salmonella typhi (S. typhi) with bacteria in the blood associated with typhoid fever or enteric fever.

S. typhi is a species of the Salmonella organism. The organism is spread via the blood stream producing bacteria in the blood. The infection spreads from its initial site (gastrointestinal tract) to the joint in which a septic condition develops. Individuals who have inflammatory bowel disease are thought to be prone to develop arthritis. Most often the peripheral joints are affected (knee, ankle, and elbow). Arthritis is thought to be an outcome of untreated typhoid fever.

The onset of the condition can be slow. There may be prolonged or recurrent fever accompanied by bacteremia and local infection in bone and joints. Signs and symptoms may include: chills; severe fever; pain in the joints (polyarthralgias); and limited movement in swollen, tender and stiff joints. There may be a rash ("rose" spots) on the trunk, with pink pimples that fade on pressure.

Tests include: complete blood count (CBC); analysis of the synovial fluid; blood culture of the synovial fluid; and culture of the bone marrow.

Systemic treatment is started immediately against the causative agent S. typhi which includes antibiotic therapy. Treatment for typhoid arthritis may also include: immobilization of the joint; passive range of motion (ROM) exercise; and quadriceps strengthening exercises.

Residuals may include limitation of the affected joint due to destruction of its articular surfaces. Most persons can recover complete joint functioning. The prognosis may be poor with complications of typhoid fever.

• The rating schedule for musculoskeletal was updated on February 7, 2021. Protection still does apply and should be considered with existing evaluations (38 CFR 3.951(a)).

• The disease must have become manifest to a degree of 10 percent or more within 1 year (for Hansen's disease (leprosy) and tuberculosis, within 3 years; multiple sclerosis, within 7 years) from the date of separation from service as specified in paragraph (a)(2) of this section. See 38 CFR 3.307(a)(3) and §3.309(a) [chronic disease].

• May be entitled to special monthly compensation where the veteran has a single service-connected disability rated as 100% with additional service-connected disability or disabilities independently ratable at 60% or more, which are separate and distinct from the 100% service-connected disability and involves different anatomical segments or bodily systems. See  38 CFR 3.350(i)(1) – Special Monthly Compensation (SMC)..

• Other specified forms of arthropathy include, but are not limited to, Charcot neuropathic, hypertrophic, crystalline, and other autoimmune arthropathies.

• With the types of arthritis, diagnostic codes 5004 through 5009, rate the acute phase under diagnostic code 5002; rate any chronic residuals under diagnostic code 5003.