Concise reports
Multiple extra-articular synovial cyst formation: case report and
review of the literature
Institute of Rheumatology, Tokyo Women's Medical
College, Tokyo, Japan
Correspondence to: Dr N Kamatani, Institute of Rheumatology, Tokyo Women's Medical College, 10-22 Kawada-cho, Shinjuku-ku, Tokyo 162, Japan.
Accepted for publication 3 February 1998
OBJECTIVE
To investigate the clinical
manifestations and the treatment strategy of a very rare entity of
disease manifesting as multiple extra-articular cystic synovitis with
recurrent polyarthralgia.
METHODSA 47 year old male patient with multiple
extra-articular synovial cysts was followed up prospectively for 13 years. The clinical manifestations and response to various treatments
were recorded. Comparisons are made among the five reported cases
(including the present case).
RESULTSMultiple synovial cysts over the tendon
sheath and bursae appeared successively with and without antecedent
growth of nodules during 13 years of follow up. Although polyarthralgia
and high titred rheumatoid factor persisted throughout the course,
there were no roentgenographical changes of joints specific to
rheumatoid arthritis (RA). The synovial cysts and arthralgia failed to
respond to any of the disease modifying anti-rheumatic drugs (DMARDs) prescribed. Systemic involvements such as pulmonary interstitial fibrosis and skin ulcers were also noted, but they were not progressive.
CONCLUSIONSMultiple extra-articular cystic
synovitis is an uncommon disease entity closely related to RA. It has
been reported exclusively in Japanese subjects and therefore some
cultural factors, either genetic or environmental, may contribute to
its development.
© 1998 by Annals of the Rheumatic Diseases
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