Case presentation 2
A 33-year-old female with no previous history, who presented to the
emergency department, on september 1st 2021, with acute left knee
arthritis evolving for 48 hours, free of fever, with prolonged morning
stiffness (more than one hour). Symptoms hindered the patient’s daily
activities, reduced her walking perimeter and disturbed her sleep
quality. Symptoms that occurred after a Covid 19 infection treated 15
days ago in ambulatory with a favorable course. On examination, there
was no fever, and besides knee arthritis, the osteoarticular examination
was normal particularly the spine, sacroiliac and hip joints. There were
no another extraarticular manifestation orienting towards rheumatic or
autoimmune diseases particularly the Systemic lupus erythematosus (SLE),
spondyloarthritis (SpA) and Behcet disease (BD). A biological
inflammatory syndrome was noted in laboratory tests with an ESR of 28 mm
and a CRP of 18.6 mg/l. The knees, hip feet and hands X-rays in front
and profile incidence were normal. A yellow fluid with multiple PNN was
detected in the joint fluid aspiration, with a negative culture. PCR for
coronavirus was negative, so was the infectious investigation. Diagnosis
of SpA, SLE and BD was eliminated by normal clinical examination,
X-Rays, pelvis MRI and immunologic investigations (ANA, RF and ACPA).
The patient was treated by analgesics and anti-inflammatory drugs. The
follow Up was highlighted by the arthritis resolution in 3 weeks and the
negativity of inflammation markers (ESR and CRP).