Poncet's disease: reactive arthritis accompanying tuberculosis. Two case reports and a review of the literature

Kroot, E. J. A.; Hazes, J. M. W.; Colin, Edgar M.; Dolhain, Radboud J E M

doi:10.1093/rheumatology/kel268

Cited by 91 publications

(88 citation statements)

References 27 publications

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“…Poncet's disease in most of the reported cases is non-erosive and non-deforming even in long-standing cases, which distinguishes it from tubercular arthritis. 7,8 In addition, the pattern of joint involvement is different in the two. Monoarticular involvement is most commonly seen in tubercular arthritis with hip and knee being the commonest joints involved.…”

Section: Discussionmentioning

confidence: 99%

“…8 Another important difference is response to ATT with a rapid resolution seen in Poncet's disease. 7 The diagnosis of Poncet's disease in most cases is clinical as there are no standard diagnostic criteria. Diag- nostic criteria have been previously proposed by Novaes et al 9 but these have not been widely used.…”

Section: Discussionmentioning

confidence: 99%

“…Patients can only be classified as a definite case of Poncet's disease after an adequate trial of ATT, hence we suggest that cases should be classified as probable or possible initially and upgraded to definite after response to ATT. We applied the criteria on our cases and the diagnosis of Poncet's arthritis was definite in 20 (cases [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] and probable in three (cases [21][22][23].…”

Section: Discussionmentioning

confidence: 99%

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A case series and review of Poncet's disease, and the utility of current diagnostic criteria

et al. 2015

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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A case series and review of Poncet's disease, and the utility of current diagnostic criteria

et al. 2015

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“…One of the most common extrapulmonary manifestations of tuberculosis is bone and joint involvement which may mimic some rheumatologic diseases. Poncet's arthritis, [4] TB arthritis, [5] peripheral septic arthritis, [6] TB spondylodiscitis and SI are some forms of presentation of extrapulmonary tuberculosis. [7][8][9][10] Even without any pathognomonic radiologic sign of TB SI, nuclear resonance showing subchondral bone marrow edema and irregularity of articular surface on an asymmetric distribution confirms unilateral SI.…”

Section: Discussionmentioning

confidence: 99%

“…These situations usually require surgical approach to yield a correct diagnosis. [3,4] Herein we present an unusual case of disseminated pelvic tuberculosis which began as unilateral sacroiliitis (SI) with progressive spread to ovaries, colon and peritoneum.…”

Section: Introductionmentioning

confidence: 99%

Sacroiliitis preceding disseminated pelvic and peritoneal tuberculosis

Carvalho¹,

Nunes

Moura

et al. 2016

CRCP

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Mycobacterium tuberculosis is the infectious agent responsible for tuberculosis (TB), one of the most common infectious causes of death in adults worldwide. It's protean manifestations may mimic different diseases in almost all clinical specialties. Herein we present a case of untreated tuberculosis sacroiliitis (SI) that evolved to disseminated pelvic disease mimicking ovarian carcinoma with peritoneal carcinomatosis. The patient complained of low back pain three years ago which was investigated with osseous scintigraphy and magnetic resonance imaging of the sacroiliac region and confirmed a left asymmetric SI. She was oriented to sporadically use of non-steroid anti-inflammatory drugs by the general physician who suspected spondiloarthropathy. Despite this, the symptoms got worse and progressed to abdominal pain, especially in hypogastric region, chronic diarrhea, severe night sweats, menstrual irregularity, weight loss, dyspareunia and undulant fever during the last year. She was admitted at this point and submitted to an exploratory video laparoscopic, the histopathology findings were strongly suggestive of disseminated pelvic TB showing granulomatous chronic inflammatory process with central caseous necrosis. The clinical team decided to initiate TB treatment, after 9 months of completed therapy, she was asymptomatic. The diagnosis of peritoneal tuberculosis usually is a challenge and invariably demands peritoneal biopsy. Mycobacterium tuberculosis can reach peritoneal tissue through the blood, lymphatic system and by contiguity. This case report presents an unusual form of pelvic and peritoneal disseminated tuberculosis preceded by a SI misdiagnosed as spondyloarthropathy.

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A Patient With Hepatitis C Virus Infection and Inflammatory Polyarthritis

Thomas

Kerr

Benator

et al. 2013

Arthritis Care & Research

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A 65-year-old African American man with a 4-year history of nontophaceous, crystal-proven polyarticular gout presented to the emergency room with a painful left leg and knee swelling of 4 days' duration. A Doppler ultrasound revealed no deep vein thrombosis, and arthrocentesis of the left knee was performed (Table 1). Monosodium urate crystals were identified. Acute gouty arthritis was diagnosed and compliance with daily colchicine was recommended, along with leg elevation. Two days later, Streptococcus viridans (resistant to penicillin and ceftriaxone) and pan-sensitive Escherichia coli grew from the synovial fluid (SF). Attempts to contact the patient were unsuccessful.Twelve days later, the patient returned to the emergency room with worsening symptoms and an unchanged examination. A repeat ultrasound of the left lower extremity revealed a Baker's cyst, but no evidence of rupture. He was treated with ibuprofen and hydrocodone/acetaminophen, and was instructed to follow up with his primary care physician. No reference was made to the prior polymicrobial SF results.Four weeks later, without any resolution in his symptoms, the patient had his third emergency room visit within 6 weeks. Examination revealed a left knee effusion with limited and painful range of motion. He was admitted for further evaluation. Medical historyThe patient admitted to a consistent diet of 1 pint of alcohol every 3 days and frequent consumption of red meat and foods containing high fructose corn syrup. He was uncertain of his compliance with prescribed daily colchicine. A recent uric acid level was 9.6 mg/dl. He had a history of significant polysubstance abuse, including alcohol, heroine, crack cocaine, and marijuana, and a 48 pack-year history of cigarette smoking, all active in the past 4 years. He also had chronic obstructive pulmonary disease and a history of a positive tuberculin purified protein derivative (PPD) without documented treatment. Two years previously, he was treated for nonresectable, squamous cell carcinoma of the esophagus with radiotherapy and capecitabine, now in remission. He had hepatitis C virus (HCV) genotype 1a complicated by cirrhosis, portal hypertension, and ascites requiring frequent therapeutic paracenteses. He was also diagnosed with hepatocellular carcinoma 2 years prior to presentation, for which he received 3 treatments with transarterial chemoembolization (TACE) with epirubicin, the most recent 2 months prior to admission. MedicationsMedications included tramadol 50 mg 3 times daily, albuterol 90 g/ipratropium 18 g 2 puffs 3 times daily, omeprazole 20 mg twice daily, and amlodipine besylate 5 mg daily. Family and social historyHe had no family history of gout, had been unemployed for several years, and was intermittently homeless. Review of SystemsThe patient denied fevers or malaise, recent dental infections, rash, sinusitis, productive cough, dysuria, nausea, vomiting, or diarrhea. He had dyspnea on exertion and wheezing. He had no chest pain, palpitations, orthopnea, or paroxysmal nocturnal dyspne...

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Poncet's disease: reactive arthritis accompanying tuberculosis. Two case reports and a review of the literature

Abstract: Both presented patients and the review of the literature demonstrate that active TB may be complicated by ReA known as Poncet's disease. Early recognition of this rare complication of TB is of major importance to avoid delayed initiation of appropriate treatment.

Cited by 91 publications

References 27 publications

A case series and review of Poncet's disease, and the utility of current diagnostic criteria

A case series and review of Poncet's disease, and the utility of current diagnostic criteria

Sacroiliitis preceding disseminated pelvic and peritoneal tuberculosis

A Patient With Hepatitis C Virus Infection and Inflammatory Polyarthritis

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