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Eosinophilic Synovitis Masquerading as Septic Arthritis in a Pediatric Patient: A Case Report and Diagnostic Insights

Nikhil Cs1, Sharafuddeen Mammu2, Jayesh Neerngat1

  • 1Depatment of Orthopedics, Baby Memorial Hospital, Kozhikode, India.

Journal of Orthopaedic Case Reports
|May 12, 2025
PubMed

Insights

Eosinophilic synovitis in children can mimic septic arthritis, complicating diagnosis. Prompt synovial fluid analysis and treatment with diethylcarbamazine led to full recovery in a pediatric case.

Area of Science:

  • Pediatric Rheumatology
  • Pediatric Infectious Diseases
  • Clinical Pathology

Background:

  • Eosinophilic synovitis is a rare inflammatory joint condition.
  • It often presents symptomatically similar to septic arthritis in children.
  • Potential causes include allergic reactions, parasitic infections, or idiopathic factors.

Observation:

  • A 4-year-old boy presented with symptoms suggestive of septic arthritis of the knee.
  • Arthrotomy and synovial fluid analysis revealed marked eosinophilia.
  • Histopathological examination confirmed eosinophilic synovitis.

Findings:

  • The pediatric patient was treated with a 3-week course of diethylcarbamazine (DEC).
  • The patient experienced complete resolution of symptoms.
  • No recurrence of the condition was observed post-treatment.

Implications:

  • Synovial fluid analysis is crucial for diagnosing pediatric monoarticular joint swelling.
  • Eosinophilic synovitis should be included in the differential diagnosis for pediatric joint inflammation.
  • Accurate diagnosis prevents misdiagnosis and unnecessary invasive treatments.
Abstract

Keywords:
Septic arthritisdiethylcarbamazineeosinophiliasynovitis

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