Bicipital synovial cyst as the sole musculoskeletal presentation of systemic juvenile idiopathic arthritis—case report

Abstract

To describe a unique presentation of fever and bilateral bicipital synovial cysts in young female with systemic juvenile idiopathic arthritis (SJIA). A previous healthy 5-year-old female presented with spiking fever and sudden painless bilateral swelling on the flexor aspect of the upper arm. Ultrasonography confirmed a cystic structure with multiple septae, thickening and tenosynovitis of bicipital tendon but without Doppler signals inside or shoulder synovitis, enlightens the term of non-articular synovitis. Thorough analysis of clinical manifestations, disease assessment measures, laboratory findings and imaging of arm swellings eventually disclosed unusual case of SJIA. Systemic juvenile idiopathic arthritis should be considered in case of spiking fever with bicipital synovial cysts. Ultrasound is a useful diagnostic tool in this condition.

Keywords:

• Systemic juvenile idiopathic arthritis
• brachial swelling
• bicipital synovial cyst
• non-articular synovitis
• ultrasound

Patient consent

My patient provided informed consent in written format to participate in this study and consent for the use of the data.

Ethical approval

This study was approved by Institutional Research Board (IRB) of the Faculty of Medicine, Mansoura University, Egypt (approval number R.20.09.1028).

Conflict of interest

None.

Data availability statement

All data generated during this study are in this published article.