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"Pseudoseptic" arthritis complicating rheumatoid arthritis: a report of six cases
J D Singleton1, S G West, D M Nordstrom
1Department of Medicine, Fitzsimons Army Medical Center, Aurora, CO 80045-5000.
Abstract:
Six cases of a severe, sterile, inflammatory arthritis mimicking septic arthritis occurred in 328 patients with rheumatoid arthritis (RA) over a 4-year period. Four patients were poorly controlled by or had recently discontinued a disease modifying antirheumatic drug. Five improved after receiving increased glucocorticoid therapy. Radiographs showed no accelerated joint destruction after a mean followup of 29.5 months (range 8-49). Recognition of "pseudoseptic" arthritis occurring in the course of RA permits appropriate therapy and avoids extended antibiotic treatment.
Insights
Severe inflammatory arthritis mimicking infection occurred in rheumatoid arthritis patients. Prompt glucocorticoid therapy improved symptoms without accelerating joint damage, avoiding unnecessary antibiotics.
Area of Science:
- Rheumatology
- Immunology
- Infectious Disease
Background:
- Rheumatoid arthritis (RA) is a chronic autoimmune disease causing joint inflammation.
- Septic arthritis requires urgent antibiotic treatment to prevent joint destruction.
Observation:
- Six cases of severe, sterile, inflammatory arthritis mimicking septic arthritis were observed in 328 RA patients over 4 years.
- Four patients had poorly controlled or recently discontinued disease-modifying antirheumatic drugs (DMARDs).
Findings:
- Five patients improved with increased glucocorticoid therapy.
- Radiographs showed no accelerated joint destruction after a mean follow-up of 29.5 months.
Implications:
- Recognizing pseudoseptic arthritis in RA is crucial for appropriate management.
- This distinction prevents prolonged and unnecessary antibiotic treatment for RA patients.