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Protracted familial mediterranean fever arthritis presenting as septic arthritis

Hale Usluer1, Zelal Bircan

  • 1Department of Pediatric Nephrology, Kocaeli University Faculty of Medicine, 41380 Umuttepe, Kocaeli, Turkey.

Rheumatology International
|March 28, 2007
PubMed

Insights

Familial Mediterranean Fever (FMF) can present as protracted arthritis, mimicking septic arthritis. Early diagnosis based on clinical history is crucial to avoid unnecessary surgeries for FMF patients.

Area of Science:

  • Rheumatology
  • Genetics
  • Internal Medicine

Background:

  • Familial Mediterranean Fever (FMF) is a genetic autoinflammatory disorder.
  • Arthritis is a common initial symptom in FMF, occurring in 25% of patients.
  • While typically self-limited, 5% of FMF cases develop protracted arthritis, often affecting large joints like the knee.

Observation:

  • Two cases are presented with protracted arthritis initially misdiagnosed as septic arthritis.
  • One patient underwent four synovectomy procedures, and the other had two, for presumed septic arthritis.
  • Subsequent detailed patient history led to a diagnosis of FMF in both individuals.

Findings:

  • Protracted arthritis in FMF can be mistaken for septic arthritis, leading to misdiagnosis.
  • The diagnostic process for FMF relies heavily on thorough medical history and clinical presentation.
  • Misdiagnosis can result in invasive and unnecessary surgical interventions.

Implications:

  • Emphasizes the critical role of clinical history in diagnosing FMF.
  • Highlights the need to consider FMF in patients presenting with unexplained protracted arthritis.
  • Aims to prevent patient suffering and avoid unnecessary surgical procedures through timely FMF diagnosis.

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