Lim Chong Hong, Lim Yuen Han, Radzi Muhammad
Rheumatology Unit, Department of Internal Medicine, Hospital Sultanah Bahiyah, Alor Setar, Kedah Darul Aman, Malaysia
Department of Internal Medicine, Hospital Sultanah Bahiyah, Alor Setar, Kedah Darul Aman, Malaysia.
BMJ Case Rep. 2020 Mar 19;13(3):e232193. doi: 10.1136/bcr-2019-232193.
A 19-year-old girl presented to the rheumatology clinic for left knee monoarthritis for the past 4 months. She also had constitutional symptoms with significant weight loss. On physical examination, she appeared cachexic, her left knee was swollen and tender. MRI of the left knee showed a soft tissue swelling extending into the knee joint. Left knee synovial fluid showed small round cells. Histopathology results were compatible with Ewing's sarcoma. Due to the delay in seeking medical advice, she succumbed to the disease 1 week after the diagnosis was made. Soft tissue/bone tumour causes monoarthritis is not common. A careful history taking, physical examination and investigations should be done in order to identify a sinister cause of monoarthritis such as Ewing's sarcoma. Early treatment should be initiated to ensure a better outcome.
一名19岁女孩因左膝单关节炎，在过去4个月里一直前往风湿病诊所就诊。她还伴有全身症状，体重显著减轻。体格检查时，她看起来消瘦，左膝肿胀且压痛。左膝的磁共振成像显示有软组织肿胀延伸至膝关节。左膝滑液显示有小圆细胞。组织病理学结果与尤因肉瘤相符。由于就医延迟，她在确诊1周后死于该病。软组织/骨肿瘤导致单关节炎并不常见。应仔细询问病史、进行体格检查和开展相关检查，以确定单关节炎的险恶病因，如尤因肉瘤。应尽早开始治疗，以确保获得更好的结果。
