The term "sympathetic synovial effusion" refers to a transudative, noninflammatory effusion occurring in a synovial-lined space contiguous to another inflamed joint, bursa, or other tissue space, presumably occurring as a reactive phenomenon in response to the inflammation (1). Sympathetic effusions have received little attention in the rheumatoiogic literature, and a general discussion of their characteristics and natural history has been lacking. We present here a case report and discussion of sympathetic effusions associated with infectious arthritis and bursitis, and a review of the available literature.Case report. A 29-year-old white woman was admitted to the hospital, with fever and left knee swelling and pain, which she had had for 6 days.Medical history included hypertension and brittle insulin-dependent diabetes mellitus, complicated by nephropathy, retinopathy, and peripheral neuropathy. Pertinent findings from the physical examination included an oral temperature of 38°C. There was diffuse

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We describe a young Hispanic man who presented with features suggestive of a diagnosis of systemic lupus erythematosus. Eventually, a bone marrow biopsy was performed, and it revealed the presence of hairy cell leukemia. This case of a lupus-like syndrome should be added to the list of reported rheumatic syndromes that are associated with hairy cell leukemia.Various rheumatic syndromes have been described in association with the presence of malignancy. The presenting symptoms are often those of the rheumatic disease rather than of the malignancy. We present here our findings in a Hispanic man whose initial signs and symptoms were consistent with a diagnosis of systemic lupus erythematosus (SLE). With worsening of his condition and failure to respond to standard therapy for SLE, he was referred to our hospital for further evaluation. During the course of the hospitalization, the patient experienced various From the