Acute synovitis, fever and rash possibly caused by metallic debris from a loosened knee prosthesis in a patient with rheumatoid arthritis.
A 39-year-old woman with long-standing seropositive rheumatoid arthritis who had a total replacement of her left knee with a modular prosthesis in 1994 presented with fever, pruritic rash, and acute synovitis of that joint following local trauma. Synovial fluid showed a charcoal-like color, and contained abundant phagocytes laden with metal particles. In patients with rheumatoid arthritis who have undergone total joint replacement, metal particle reactions and possible hyper-sensitivity should be added to the list of potential causes of superimposed acute synovitis and systemic manifestations.
Engler
J
J
Centro Nacional de Enfermedades Reumáticas, Division of Rheumatology, Hospital Universitario de Caracas, Hospital de Clínicas Caracas, Caracas, Venezuela.
Paul
H
H
Gamardo
J
J
Rodríguez
M A
MA