Journal List > Hip Pelvis > v.24(4) > 1081959

Park, Lee, Kim, Hurr, Chun, Rhyu, and Cho: Acute Phase of Sero-negative Rheumatoid Arthritis Misdiagnosed as Pyogenic Arthritis - A Case Report -

Abstract

In cases of sero-negative rheumatoid arthritis (RA), no abnormal findings are observed on blood tests and its clinical course is favorable, compared to sero-positive RA. In the acute phase of sero-negative RA, infiltration of neutrophils may be the only pathologic finding on frozen section biopsy. Thus, it might be misdiagnosed as pyogenic arthritis. We report on a case of acute sero-negative RA misdiagnosed as pyogenic arthritis during hip surgery with review of the literature.

Figures and Tables

Fig. 1
Preoperative radiographs of the hip joint showing sclerotic change of both femoral head, subchondral bone cysts & fracture, joint destructive change. (A) AP view, (B) Frogleg view.
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Fig. 2
MRI view showing joint fluid collection, synovial hypertrophy, subchondral bone cyst & fracture. (A) T1 weighted coronal view (B) T2 weighted coronal view.
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Fig. 3
Postoperative radiographs showing antibiotics pregnated cement spacer insertion of the right hip joint.
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Fig. 4
(A) Histologic examination of hematoxyline and eosin stained specimen showed of neutrophils infiltration in the tissues around the hip joint and did not show the lymphoid follicle (×100). (B) The same findings above figure (×400), (C) Small pannus (dark arrow) formation ingrowing cartilage (×100).
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