Pseudogout of the Knee after Intraarticular Injection of Hyaluronic Acid.
10.4055/jkoa.2014.49.6.476
- Author:
Ho Seung JEON
1
;
Young Kyun WOO
;
Seok Ha HWANG
;
Seung Pyo SUH
;
Joon Kyung LEE
Author Information
1. Department of Orthopedic Surgery, Sung-Ae Hospital, Seoul, Korea. arcseo@hanmail.net
- Publication Type:Case Report
- Keywords:
knee;
intra-articular injections;
hyaluronic acid;
chondrocalcinosis
- MeSH:
Aged, 80 and over;
Arthritis;
C-Reactive Protein;
Calcium Pyrophosphate;
Chills;
Chondrocalcinosis*;
Female;
Fever;
Heating;
Hematologic Tests;
Hospitalization;
Hot Temperature;
Humans;
Hyaluronic Acid*;
Injections, Intra-Articular*;
Knee*;
Korea;
Leukocytes;
Osteoarthritis;
Sensation;
Synovial Fluid
- From:The Journal of the Korean Orthopaedic Association
2014;49(6):476-479
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
An 82-year-old woman underwent surgery for the left intertrochanteric fracture. However, during hospitalization, she complained of pain on the right knee. Radiographs showed moderately degenerative arthritis and intrameniscal calcification. Hyaluronic acid was administered by intraarticular injection. After injection, arthritic symptoms improved. Five days after injection, she complained of severe pain, swelling, and heating sensation in the right knee with chills and fever. Blood test showed elevated white blood cell (WBC) count and C-reactive protein. WBC in synovial fluid increased to 47,250/mm3. Antimicrobial therapy was administered under the impression of acute pyogenic arthritis by adverse reaction of hyaluronic acid injection. Polarization microscope showed calcium pyrophosphate dihydrate crystals. Synovial fluid culture was negative. Finally, she was diagnosed as pseudogout. The symptoms improved within one week. To our knowledge, there has been no report of pseudogout following intraarticular injection of hyaluronic acid in Korea. Therefore, we report this case with a review of the literature.
