title: Malignant joint effusions secondary to solid tumor metastasis.
abstract: We describe the case of a patient with breast cancer who developed bilateral malignant knee effusions, and review the English language literature. Patients with solid tumors who develop malignant joint effusions are rare; 27 cases have been reported (including our patient). The knee is the predominant site of joint involvement (p < 0.001). Synovial fluid (SF) analysis often demonstrates noninflammatory bloody effusion. Synovial biopsy was positive in 11 of 16 cases in which it was performed. SF cytology was positive in one half of cases in which it was obtained. Arthritis secondary to metastasis is a poor prognostic finding. A strong clinical suspicion is necessary to make the diagnosis; SF cytology or synovial biopsy can confirm it.
authors.affiliation: Department of Internal Medicine, University of Kentucky, Lexington, USA.
authors.forename: R K
authors.initials: RK
authors.lastname: Munn
authors.forename: S T
authors.initials: ST
authors.lastname: Pierce
authors.forename: D
authors.initials: D
authors.lastname: Sloan
authors.forename: J A
authors.initials: JA
authors.lastname: Weeks
mesh_terms: D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary*; D001943:Breast Neoplasms; D018270:Carcinoma, Ductal, Breast / Q000000981:diagnostic imaging / Q000556:secondary*; D005122:Exudates and Transudates / Q000000981:diagnostic imaging; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007594:Joint Loose Bodies / Q000000981:diagnostic imaging / Q000209:etiology*; D007719:Knee Joint / Q000000981:diagnostic imaging; D008875:Middle Aged; D011859:Radiography; D017556:Technetium Compounds
chemical_list: D017556:Technetium Compounds