Knee Effusion with Peripheral Eosinophilia: A Need to Rule out Idiopathic Eosinophilic Synovitis
Dr. Gaurav Kumar Upadhyaya,
Department of Orthopaedics, AIIMS, Raebareli-229405, Uttar Pradesh, India.
Synovial Fluid Eosinophilia (SFE) is a rare finding. Minor SFE is defined as <10% eosinophils of the total leucocyte count in Synovial Fluid (SF), and major SFE as >10% eosinophils of the total leucocyte count in SF. The aetiology and pathophysiology of eosinophilic synovitis is unclear. Most commonly affected joints are Knees; however ankle, elbow and metatarso-phalangeal joint involvement is also being reported. A 10-year-old girl reported with history of pain, swelling and difficulty in bending left knee since five days. On the basis of investigations such as blood investigations including complete blood count, Rheumatoid factor, filarial card test etc., radiographs of knee and arthrocentesis of knee, she was diagnosed as Eosinophilic Synovitis of Knee with peripheral eosinophilia without any known cause. She was treated with Ibuprofen 200 mg BD for 10 days and was relieved of her complaints. After one and half year of follow-up, there were no episodes of recurrent pain or swelling and patient was doing well.