Synovial sarcoma masquerading as juvenile idiopathic arthritis.

Publication date: Dec 05, 2024

An early adolescent girl presented with chronic deforming monoarthritis. Initially misdiagnosed with skeletal tuberculosis, she received empirical treatment despite the absence of microbiological evidence. Her symptoms were managed intermittently with non-steroidal anti-inflammatory drugs, but the persistence and progression of her condition over the past 4 months raised suspicions of juvenile idiopathic arthritis. Her clinical presentation deteriorated, with severe knee arthritis and rapid calf swelling, prompting differential diagnosis including necrotising fasciitis or a ruptured Baker’s cyst. Imaging confirmed synovitis with localised necrotising myositis, while persistent pain after fascial release and systemic inflammation without signs of infection indicated a more sinister underlying condition. Histopathological analysis of the biopsied tissue revealed synovial sarcoma, with subsequent PET-CT confirming skeletal and pulmonary metastasis. Despite timely diagnosis, the patient ultimately succumbed to her illness.

Concepts Keywords
4months Adolescent
Baker Arthritis, Juvenile
Ct Diagnosis, Differential
Steroidal Fatal Outcome
Tuberculosis Female
Humans
Lung Neoplasms
Musculoskeletal syndromes
Paediatric oncology
Sarcoma, Synovial

Semantics

Type Source Name
disease MESH Fatal Outcome
disease MESH metastasis
disease MESH infection
disease MESH inflammation
pathway REACTOME Release
disease MESH myositis
disease MESH synovitis
disease MESH Baker’s cyst
disease MESH fasciitis
disease MESH arthritis
pathway KEGG Tuberculosis
disease MESH tuberculosis
disease MESH juvenile idiopathic arthritis
disease MESH Synovial sarcoma
disease MESH Lung Neoplasms
disease MESH syndromes

Original Article

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