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Document Details :
Title: Een 37-jarige man met pijn en zwelling ter hoogte van beide enkels
Author(s): SERMIJN E, THEUNISSEN C, VAN LAER W, LACOR P
Journal: Tijdschrift voor Geneeskunde
Volume: 61 Issue: 6 Date: 2005
A 37-year-old male patient with a painful swelling of both ankles
A 37-year-old male presents with an acute arthritis of both ankles. A blood test reveals an increased leukocyte count and an inflammatory pattern, with elevation of sedimentation rate and CRP as well as fibrinogen levels.
Thoracic X-ray shows a bilaterally enlarged hilar shadow. A CT scan confirms the presence of enlarged mediastinal and hilar lymph nodes. On a biopsy of lung tissue obtained by bronchoscopy, non-caseating granulomas are found. The diagnosis of sarcoidosis presenting as an acute sarcoid arthritis is thus made.
This case report illustrates the need for awareness of the clinician of less frequent diseases when confronted with a patient with acute articular symptoms.