rss
Ann Rheum Dis doi:10.1136/ard.2007.075333

Isolated knee monoarthritis heralding resectable non small-cell lung cancer. A paraneoplastic syndrome not previously described.

  1. Fabrizio Cantini (fcantini{at}usl4.toscana.it)
  1. Hospital of Prato, Italy
    1. Laura Niccoli (lniccoli{at}usl4.toscana.it)
    1. Hospital of Prato, Italy
      1. Carlotta Nannini (tatta77{at}tiscali.it)
      1. Hospital of Prato, Italy
        1. Daniela Chindamo (dchindamo{at}usl4.toscana.it)
        1. Hospital of Prato, Italy
          1. Michele Bertoni (mbertoni{at}usl4.toscana.it)
          1. Hospital of Prato, Italy
            1. Emanuele Cassarà (ecassara{at}usl4.toscana.it)
            1. Hospital of Prato, Italy
              1. Carlo Salvarani (salvarani.carlo{at}asmn.re.it)
              1. Arcispedale S Maria Nuova, Italy
                • Published Online First 3 September 2007

                Abstract

                Objective: To describe isolated knee monoarthritis as a paraneoplastic syndrome heralding non-small cell lung cancer (NSCLC), and to discuss its clinical characteristics.

                Methods: We reviewed the clinical records of all consecutive, new outpatients with isolated knee monoarthritis observed from January 2000 to December 2005. A systematic review of Medline and Cochrane Library databases was performed to identify English-language articles related to rheumatologic paraneoplastic syndromes associated with NSCLC.

                Results: Over 6 years, we observed 6654 new outpatients with different rheumatic disorders. Of these, 296 (4.4%) presented with isolated monoarthritis of the knee. In 5 out of 296 (1.7%) patients this feature represented the initial manifestation of NSCLC. All 5 patients were middle aged males, with a long history of heavy cigarette smoking, who had a nonerosive, isolated knee monoarthritis, with mild articular fluid collection of non inflammatory type. NSCLC was resectable in all patients, and knee monoarthritis remitted with no relapse confirming its paraneoplastic nature. All 5 patients are in good condition after a median follow up of 41 months. The literature review revealed that paraneoplastic knee monoarthritis has not been previously reported.

                Conclusion: Knee monoarthritis may represent in some cases a paraneoplastic syndrome heralding NSCLC in an early stage.

                This Article

                1. Abstract
                2. PDF
                3. All versions of this article:
                  1. ard.2007.075333v1
                  2. 66/12/1672most recent

                Responses

                1. Submit a response
                2. No responses published

                Register for free content

                The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.

                Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.