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Acute polyarthritis associated with birefringent lipid microspherules occurring in a patient with longstanding

C Rivest1, M Hazeltine, G Gariepy

  • 1Division of Rheumatology and Pathology, Saint-Luc Hospital, University of Montreal, Quebec, PQ.

The Journal of Rheumatology
|April 1, 1992
PubMed

Insights

This study reports a rare case of acute polyarthritis in a patient with rheumatoid arthritis (RA). Lipid microspherules were found in synovial fluid, suggesting a novel association in RA patients.

Area of Science:

  • Rheumatology
  • Crystal Arthropathies
  • Synovial Fluid Analysis

Background:

  • Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by joint inflammation.
  • Patients with RA can experience various complications and comorbidities.
  • Acute polyarthritis presents as sudden onset joint pain and swelling affecting multiple joints.

Observation:

  • A 52-year-old female patient with a history of rheumatoid arthritis presented with acute polyarthritis affecting her hands and wrists.
  • Synovial fluid was aspirated from the affected joints for analysis.
  • Microscopic examination of the synovial fluid was performed.

Findings:

  • Synovial fluid analysis revealed the presence of intra- and extracellular lipid microspherules.
  • These microspherules exhibited the characteristic Maltese cross appearance under polarized light microscopy.
  • No other specific cause for the acute polyarthritis was identified.

Implications:

  • This case represents the first documented instance of acute polyarthritis associated with lipid microspherules in a patient with rheumatoid arthritis.
  • The findings suggest a potential, previously unrecognized link between lipid microspherules and inflammatory arthritis in RA.
  • Further research is warranted to elucidate the pathogenesis and clinical significance of lipid microspherules in rheumatoid arthritis.

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