Misleading radiological diagnosis in recurrent septic arthritis
Safiye Koçulu1, Vefa Atansay2, Işık Karalök3, Ayhan Nedim Kara2, Neslihan Aksu2
1Demiroğlu Bilim Üniversitesi Tıp Fakültesi Enfeksiyon Hastalıkları ve Mikrobiyoloji Anabilim Dalı, İstanbul, Türkiye
2Demiroğlu Bilim Üniversitesi Tıp Fakültesi Ortopedi ve Travmatoloji Anabilim Dalı, İstanbul, Türkiye
3Demiroğlu Bilim Üniversitesi Tıp Fakültesi Radyoloji Anabilim Dalı, İstanbul, Türkiye
Keywords: Abscess, differential diagnosis, hematoma, infection, septic arthritis, systemic lupus erythematosus
Abstract
Systemic lupus erythematosus (SLE) is a rheumatologic disease characterized with relapses which may require long-term corticosteroid treatment. Avascular necrosis and septic arthritis of the joints can be seen in patients with SLE, secondary to the corticosteroid treatment. Because the disease itself and the corticosteroid treatment cause changes in the acute phase reactant levels, it is difficult to differentiate abscess from hematoma by using laboratory tests. Particularly in complicated cases, differentiation of abscess and hematoma is challenging even with the use of different radiological modalities. In this article, we report a 53-year-old male patient who was operated due to bilateral recurrent septic arthritis and received a final diagnosis of hematoma. The aim of this report is to emphasize that hematoma should be considered in the differential diagnosis of septic arthritis.