[Errors in the evaluation of osteoarticular symptoms]

Area of Science:

• Rheumatology
• Oncology
• Clinical Medicine

Background:

• Osteoarticular symptoms can present diagnostic challenges, mimicking various conditions.
• Differentiating between rheumatic diseases and neoplastic aetiologies requires careful clinical evaluation.

Observation:

• Two patients with osteoarticular symptoms are presented.
• The first patient's symptoms were initially treated as rheumatic disease, with neoplastic aetiology considered only after treatment failure.
• The second patient's articular complaints were initially suspected to be a paraneoplastic syndrome, but the subsequent course revealed rheumatoid arthritis with atypical Caplan syndrome.

Findings:

• Misdiagnosis can occur in osteoarticular conditions, delaying appropriate treatment.
• Rheumatoid arthritis can manifest with atypical presentations, such as Caplan syndrome.
• Neoplastic aetiology should be considered in refractory osteoarticular symptoms.

Implications:

• Clinicians should maintain a broad differential diagnosis for osteoarticular symptoms.
• Early consideration of less common causes like atypical Caplan syndrome can improve patient outcomes.
• Further research into paraneoplastic syndromes and their differentiation from primary rheumatic diseases is warranted.