UNUSUAL AND MEMORABLE

Case number 34: Relapse of polyarteritis nodosa presenting as isolated and localised lower limb periostitis

P Carron¹, I E A Hoffman¹, L De Rycke¹, I Peene¹, E M Veys¹, F De Keyser¹, W Bauters², M Praet³

¹ Department of Rheumatology, Ghent University Hospital, Belgium
² Department of Radiology, Ghent University Hospital, Belgium
³ Department of Pathology, Ghent University Hospital, Belgium

Correspondence to:
Correspondence to:
Dr I Hoffman
Department of Rheumatology, Ghent University Hospital, De Pintelaan 185, 9000 Gent, Belgium; Ilse.Hoffman@UGent.be

Keywords: periostitis; polyarteritis nodosa

The first 150 words of the full text of this article appear below.

A 59 year old woman presented with progressively increasing pain and swelling over the right lower limb that had started at the end of 2001. No systemic manifestations such as fever, weight loss, arthralgia, myalgia, or rash were present. Upon examination we noticed a painful swelling localised over the middle one third of the right tibia without cutaneous alterations. There were no other pathological clinical signs. At that time, she was taking no drugs.

Her medical history disclosed systemic polyarteritis nodosa (PAN) in 1991, at which time she presented with pain and swelling at the knees and ankles as well as cutaneous nodules over the medial side of the left ankle. This clinical presentation, together with the inflammatory biology, the absence of autoantibodies, the presence of radiological and scintigraphic periostitis, and the finding of microaneurysms upon arteriography, led to the diagnosis of PAN. She was successfully treated with corticosteroids over . . . [Full text of this article]

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This article has been cited by other articles:

• Khellaf, M, Hamidou, M, Pagnoux, C, Michel, M, Brisseau, J M, Chevallier, X, Cohen, P, Guillevin, L, Godeau, B (2007). Vasculitis restricted to the lower limbs: a clinical and histopathological study. Ann Rheum Dis 66: 554-556 [Abstract] [Full Text]