title: Acute synovitis, fever and rash possibly caused by metallic debris from a loosened knee prosthesis in a patient with rheumatoid arthritis.
abstract: 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.
authors.affiliation: Centro Nacional de Enfermedades Reumáticas, Division of Rheumatology, Hospital Universitario de Caracas, Hospital de Clínicas Caracas, Caracas, Venezuela.
authors.forename: J
authors.initials: J
authors.lastname: Engler
authors.forename: H
authors.initials: H
authors.lastname: Paul
authors.forename: J
authors.initials: J
authors.lastname: Gamardo
authors.forename: M A
authors.initials: MA
authors.lastname: Rodríguez