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What Causes Knee Swelling And Recurrent Fever In A Child?

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Posted on Thu, 24 Sep 2015
Question: The patient is suffering from swelling in knee joints and have high fever sometimes . the Rheumatologist are unable to exactly identify the disease as most of the diagnosis reports pertaining to Rheumatology are normal. During last week he got high myopia with cylindrical numbers which may also have happened due to this. his DoB is 30 May 2010. The reports are attached herewith for your reference. Pls guide us.
doctor
Answered by Dr. Dr. Alokkalyani (1 hour later)
Brief Answer:
seronegative arthritis

Detailed Answer:
Hi,

I have gone through all history and reports and understand that confusion is due to negative tests.
In rheumatology practice, syndromic approach is essential, i.e taking symptoms collectively.
So for the knee swelling and on and off fever in a kid - there are only three broad possibilities:
One is infection, Second is rheumatological disorder and third rare cause is leukemia - which is already ruled out.
If infection is ruled out by blood culture, urine culture, knee fluid culture, serum procalcitonin and a trial of antibiotics, then we safely assume that it is a case of rheumatological disorder.
In this condition, we usually go for battery of tests. In your case the tests are negative but still there are many conditions where these tests comes negative. We still make diagnosis and treat them as per clinical finding with a diagnosis of seronegative JIA/ sjogren syndrome. In fact you can go for two more blood tests C1 inhibitor antigen and C1INH function.

In my opinion the treating doctor can go with this and start treatment.

Hope this will help...

Thanks, if you have further queries, please do not hesitate to ask.
Note: For further information on diet changes to reduce allergy symptoms or to boost your immunity, Ask here.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Dr. Alokkalyani

Rheumatologist

Practicing since :1999

Answered : 519 Questions

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What Causes Knee Swelling And Recurrent Fever In A Child?

Brief Answer: seronegative arthritis Detailed Answer: Hi, I have gone through all history and reports and understand that confusion is due to negative tests. In rheumatology practice, syndromic approach is essential, i.e taking symptoms collectively. So for the knee swelling and on and off fever in a kid - there are only three broad possibilities: One is infection, Second is rheumatological disorder and third rare cause is leukemia - which is already ruled out. If infection is ruled out by blood culture, urine culture, knee fluid culture, serum procalcitonin and a trial of antibiotics, then we safely assume that it is a case of rheumatological disorder. In this condition, we usually go for battery of tests. In your case the tests are negative but still there are many conditions where these tests comes negative. We still make diagnosis and treat them as per clinical finding with a diagnosis of seronegative JIA/ sjogren syndrome. In fact you can go for two more blood tests C1 inhibitor antigen and C1INH function. In my opinion the treating doctor can go with this and start treatment. Hope this will help... Thanks, if you have further queries, please do not hesitate to ask.