Rheumatology Medical News about monoarthritis

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An unusual case of knee monoarthritis
International Journal of Rheumatic Diseases, 07/20/09

Agarwal V et al. – A 61–year–old woman, a known case of diabetic nephropathy on chronic ambulatory peritoneal dialysis, presented with acute onset severe pain in the right knee, of 7 days duration. She had red hot and tender knee and was unable to bear weight.

Exclusive Author Commentary
Dr Vikas Agarwal, 07/30/09

A 61-year old lady with diabetic nephropathy on CAPD, had presented with acute onset right knee monoarthritis with red, hot, swollen and tender right thigh and inability to bear weight. Her glycemic control was poor. A strong possibility of septic arthritis was considered. However, synovial fluid was bland and cultures were negative. Response to empirical antibiotics and analgesics was poor. Few weeks later, magnetic resonance imaging of the right thigh showed heterogeneously hyperintense right vastus medialis on T2 weighted image suggestive of diabetic muscle infarction. This case highlights a rare complication of diabetes mellitus that mimicked a more common scenario i.e. septic arthritis. This case is presented to sensitize the physicians to consider a possibility of diabetes muscle infarction in a setting of diabetes mellitus so as to avoid the delay in diagnosis and management.

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