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).