A few weeks ago, a young patient (24yo) was admitted to our hospital\u00a0 with complaints of bilateral ankle pain, swelling and redness or “periarthritis” for 1 day with no other systemic symptoms.\u00a0<\/p>\n
On ankle exam, was found to have pain with active\u00a0movements of the ankle but none with passive. +tenderness along posterior tibialis and peroneus\u00a0tendons bilaterally.<\/p>\n
Evaluation for a young patient with b\/l peri-arthritis in as follows (as was done in our patient):<\/p>\n
– CXR (to evaluate for sarcoidosis- he was found to\u00a0have bilateral hilar lymphadenopathy)<\/p>\n
– ANA, ALSO, urine GC Ag\/PCR (negative)<\/p>\n
– HIV screen\/PPD (negative, PPD pending)<\/p>\n
– other infectious work-up as indicated by history<\/p>\n
He was diagnosed with Lofgren’s syndrome (triad of bilateral arthritis + hilar lymphadenopathy + erythema nodosum) even though he did not have the third component which is more common in females with Lofgren’s. Biopsy is NOT indicated for confirmation of the diagnosis.<\/p>\n
Treatment: He was treated with NSAIDs, responded partially and then given SSKI (saturated solution of iodide). Steroid would be the next line.<\/p>\n
Prognosis: Excellent for Lofgren’s with 95% resolution of symptoms by 2 years.<\/p>\n
NEJM review article<\/a>;\u00a0Educational slides with patient’s images<\/a><\/p>\n","protected":false},"excerpt":{"rendered":" A few weeks ago, a young patient (24yo) was admitted to our hospital\u00a0 with complaints of bilateral ankle pain, swelling and redness or “periarthritis” for 1 day with no other systemic symptoms.\u00a0 On ankle exam, was found to have pain with active\u00a0movements of the ankle but none with passive. +tenderness along posterior tibialis and peroneus\u00a0tendons […]<\/p>\n","protected":false},"author":5942,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[4854],"tags":[],"_links":{"self":[{"href":"https:\/\/www.bumc.bu.edu\/im-residency\/wp-json\/wp\/v2\/posts\/4550"}],"collection":[{"href":"https:\/\/www.bumc.bu.edu\/im-residency\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.bumc.bu.edu\/im-residency\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.bumc.bu.edu\/im-residency\/wp-json\/wp\/v2\/users\/5942"}],"replies":[{"embeddable":true,"href":"https:\/\/www.bumc.bu.edu\/im-residency\/wp-json\/wp\/v2\/comments?post=4550"}],"version-history":[{"count":1,"href":"https:\/\/www.bumc.bu.edu\/im-residency\/wp-json\/wp\/v2\/posts\/4550\/revisions"}],"predecessor-version":[{"id":4886,"href":"https:\/\/www.bumc.bu.edu\/im-residency\/wp-json\/wp\/v2\/posts\/4550\/revisions\/4886"}],"wp:attachment":[{"href":"https:\/\/www.bumc.bu.edu\/im-residency\/wp-json\/wp\/v2\/media?parent=4550"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.bumc.bu.edu\/im-residency\/wp-json\/wp\/v2\/categories?post=4550"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.bumc.bu.edu\/im-residency\/wp-json\/wp\/v2\/tags?post=4550"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}