Septic arthritis mimic unmasked: inflammatory bowel disease-associated arthritis in a patient with a learning disability.
Nilesh Patel
✦ AI-curated · Sources linked
Case in brief
A man in his early 30s with a mild learning disability presented with acute left-knee pain, swelling, erythema, and fevers, alongside low-back and hip pain. Initial tests suggested septic arthritis, but cultures were negative. Further investigation revealed a year of intermittent diarrhea, leading to a diagnosis of Crohn's disease. Treatment with prednisone, methotrexate, and infliximab resulted in significant improvement and resolution of symptoms.
Diagnostic / clinical pearl
Clinicians should consider inflammatory bowel disease as a potential underlying cause of arthritis, especially in patients with communication barriers who may not report gastrointestinal symptoms.
Why it matters
This case highlights the importance of thorough history-taking and consideration of atypical presentations in patients with learning disabilities, which can lead to misdiagnosis.