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July 8, 1974

Acute Monarticular Arthritis Following Patellar Metastasis: A Manifestation of Carcinoma of the Lung

Author Affiliations

From the Rheumatology Section (Dr. Gall), Department of Medicine, and the Orthopedic Surgery Department (Dr. Didizian), University of Pennsylvania School of Medicine, and Philadelphia General Hospital (Dr. Didizian), and the Department of Pathology (Dr. Park), Philadelphia General Hospital, Philadelphia. Dr. Gall is now with the University of Arizona Medical Center, Tucson.

JAMA. 1974;229(2):188-189. doi:10.1001/jama.1974.03230400050033

METASTATIC neoplasm to the patella is unusual, and a monarticular arthritis related to such a lesion appearing as the initial sign of a previously unrecognized carcinoma must be rare indeed. In most cases of arthritis associated with malignant neoplasms, the underlying tumor is evident. We describe a patient with monarticular arthritis secondary to metastatic patellar spread of bronchogenic carcinoma as the earliest symptom of his primary tumor.

Report of a Case  A 63-year-old man was admitted to the hospital for evaluation of arthritis in the left knee.The patient had been initially hospitalized at a sanatorium in 1968 for suspected pulmonary tuberculosis; sputum cultures were negative. In spite of this, he received triple antituberculous drug therapy for one year. Three months before his final admission, he noted pain in the left knee, following a fall. The knee became increasingly swollen until he was unable to bear weight. Chest x-ray films