Pseudoseptic arthritis is an acute inflammatory monoarthritis that clinically mimics septic arthritis. We encountered an 86-year-old male with a past medical history of hypertension, type 2 diabetes mellitus, and chronic kidney disease (CKD) stage 3 who presented in the emergency department with acute onset of severe left knee joint pain and was started on antibiotics for suspected septic arthritis. Septic arthritis was ruled out with negative synovial fluid culture. Timely initiation of steroids rapidly improved his condition, and he was discharged in stable condition on the 7th day of admission. Though pseudoseptic arthritis has been reported in a variety of settings including rheumatoid arthritis, ankylosing spondylitis, and medication such as intraarticular hyaluronic acid injection, our case report presents a case of pseudoseptic arthritis as the initial presentation of undiagnosed psoriatic arthritis.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8148623PMC
http://dx.doi.org/10.7759/cureus.14660DOI Listing

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Article Synopsis
  • Pseudoseptic arthritis, a rare complication of viscosupplementation for osteoarthritis, can occur despite the treatment being generally considered safe.
  • A 61-year-old female patient experienced this rare condition shortly after receiving bilateral viscosupplementation injections, showing symptoms like knee swelling and elevated inflammatory markers.
  • Successful management was achieved through careful monitoring and non-antibiotic treatments, highlighting that antibiotics may not always be necessary in such cases.
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Pseudoseptic arthritis is a rare complication of hyaluronic acid (HA) injections that often is difficult to differentiate from septic arthritis. Patients present acute pain, swelling and joint effusion normally around 24h after the second or third HA infiltration. We describe a female patient with seropositive rheumatoid arthritis and flare-ups of knee arthritis with pseudoseptic features in the past, who develops pseudoseptic arthritis of the knee following her first injection of hyaluronic acid.

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A variety of intra-articular injections are used for the management of osteoarthritis. A rare complication of intra-articular injections is acute pseudoseptic arthritis, which mimics true septic arthritis. To the authors knowledge, pseudosepsis has not been reported as a complication after platelet-rich plasma (PRP) injections.

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Background: Persistent shoulder pain and dysfunction after vaccination are relatively rare but well-known complications after inoculations into the deltoid muscle. The term SIRVA (shoulder injury related to vaccine administration) is frequently used to encompass many of these occurrences; however, multiple distinct pathologies with similar presentations have been reported after vaccination. We performed a systematic review of the literature on vaccine-related shoulder injuries to help guide practitioners in appropriate workup and treatment based on specific diagnoses.

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Background: NLRP3-associated autoinflammatory diseases (NLRP3-AID) are rare genetic autoinflammatory diseases characterized by chronic inflammation and an urticaria-like rash. We report an unusual presentation of severe NLRP3-AID resulting in a significant diagnostic delay of more than three decades.

Case Presentation: The patient presented with early-onset serositis as well as prominent peripheral eosinophilia with organ infiltration, in the absence of the classic urticaria-like rash.

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