Article Text
Aseptic inflammation of prosthetic knee in a patient affected by rheumatoid arthritis
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Description
A woman aged 40 years affected by an aggressive and active form of rheumatoid arthritis (RA) underwent total knee arthroplasty (TKA) of the left knee for persistent synovitis after several therapeutic lines, the last one included methotrexate and a TNF-inhibitor.
Two months after the surgical procedure, the patient reported mild fever and persistent swelling of the left knee. On examination, there were signs of inflammation but no effusion to drain. Ultrasonography only showed oedema of the tissues surrounding the knee, and therefore, suspecting a prosthetic infection, antibiotic therapy was immediately started.
A subsequent scintigraphy with 99mTC-HmPAO (hexamethylpropylene-amine-oxime)-labelled leucocytes …