Lipid microspherule-associated acute monarticular arthritis.

We describe the fifth reported case of acute monarthritis associated with lipid microspherules. A 33-year-old obese man developed acute knee arthritis with a synovial fluid white blood cell count of 11,700/mm3 (97% polymorphonuclear leukocytes). The fluid contained numerous strongly positively birefringent intra- and extracellular spherules that measured 2-6 microns in diameter and had the appearance of Maltese crosses. No systemic lipid disorder or local trauma could account for the attack, which responded promptly to the administration of colchicine.