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Case report
Delayed diagnosis of Ewing’s sarcoma in a young patient presented with left knee monoarthritis
  1. Chong Hong Lim1,
  2. Yuen Han Lim2 and
  3. Muhammad Radzi3
  1. 1Rheumatology Unit, Department of Internal Medicine, Hospital Sultanah Bahiyah, Alor Setar, Kedah Darul Aman, Malaysia
  2. 2Department of Internal Medicine, Hospital Sultanah Bahiyah, Alor Setar, Kedah Darul Aman, Malaysia
  3. 3Gastroenterology Unit, Department of Internal Medicine, Hospital Sultanah Bahiyah, Alor Setar, Kedah Darul Aman, Malaysia
  1. Correspondence to Dr Chong Hong Lim; chong_hong{at}hotmail.com

Abstract

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.

  • musculoskeletal syndromes
  • orthopaedics
  • paediatric oncology
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Footnotes

  • Contributors CHL helped in conceptualisation, investigation, managing patient, writing (original draft and editing) and proofreading. YHL helped in investigation, managing patient and proofreading. MR helped in resources, investigation and proofreading.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Parental/guardian consent obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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