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Ewing's sarcoma presenting as monoarthritis.

E E McGirr, J P Edmonds

    The Journal of Rheumatology
    |August 1, 1984
    PubMed
    Summary

    Malignancy can present as joint pain. A young woman

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    Area of Science:

    • Orthopedic Oncology
    • Rheumatology
    • Diagnostic Pathology

    Background:

    • Monoarthritis, characterized by inflammation of a single joint, often presents with symptoms mimicking septic arthritis, necessitating prompt diagnosis.
    • Ewing sarcoma, a rare malignant bone tumor, typically affects long bones and can present with varied clinical manifestations.

    Observation:

    • A 22-year-old female patient presented with monoarthritis, initially suspected to be septic arthritis due to purulent synovial fluid.
    • Synovial biopsy revealed chronic synovitis, but further analysis of the synovial fluid identified malignant cells.

    Findings:

    • The malignant cells in the synovial fluid were confirmed to originate from a Ewing sarcoma of the distal femur.
    • This case highlights the diagnostic challenge where a bone malignancy presented as an isolated joint inflammation.

    Implications:

    • Malignancy should be included in the differential diagnosis for unexplained monoarthritis, especially when septic arthritis is suspected but not confirmed.
    • This case underscores the importance of comprehensive analysis of synovial fluid, including cytological examination for malignant cells, in atypical presentations of joint inflammation.

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