Article Text

other Versions

Isolated knee monoarthritis heralding resectable non small-cell lung cancer. A paraneoplastic syndrome not previously described.
  1. Fabrizio Cantini (fcantini{at}
  1. Hospital of Prato, Italy
    1. Laura Niccoli (lniccoli{at}
    1. Hospital of Prato, Italy
      1. Carlotta Nannini (tatta77{at}
      1. Hospital of Prato, Italy
        1. Daniela Chindamo (dchindamo{at}
        1. Hospital of Prato, Italy
          1. Michele Bertoni (mbertoni{at}
          1. Hospital of Prato, Italy
            1. Emanuele Cassarà (ecassara{at}
            1. Hospital of Prato, Italy
              1. Carlo Salvarani (salvarani.carlo{at}
              1. Arcispedale S Maria Nuova, Italy


                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.

                • NSCLC early diagnosis
                • hypertrophic osteoarthropathy
                • knee monoarthritis
                • non small-cell lung cancer
                • rheumatic paraneoplastic syndromes

                Statistics from

                Request Permissions

                If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.