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Rare disease
Primary Sjögren’s syndrome with tuberculous arthritis of left knee
  1. Ting Zhang1,
  2. Jia Cong2,
  3. Dong Xu1,
  4. Xiaomei Leng1,
  5. Fengchun Zhang1
  1. 1Rheumatology Department, Peking Union Medical College Hospital, Beijing, China
  2. 2Medical Department, Peking Union Medical College Hospital, Beijing, China
  1. Correspondence to Dr Dong Xu, xudong741031{at}


A 56-year-old woman presented with recurrent pain and swelling of left knee, Raynaud’s phenomenon and dry mouth. She was initially diagnosed with primary Sjögren’s syndrome and was put on prednisone, which substantially relieved her complaints. But 8 months later, pain and swelling of left knee recurred with spiking fever, chills and shortness of breath. Escalation of prednisone did not improve the pain and swelling of left knee. CT of chest revealed pulmonary interstitial changes with coexisting infection. MRI of left knee was highly consistent with tuberculous arthritis, which was further confirmed by positive blood culture of Mycobacterium tuberculosis and acid-fast stain of synovial fluid.

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  • Competing interests None.

  • Patient consent Obtained.