Monthly swelling of the knee Case report and review of the literature.
INTRODUCTION We report a 17 year old with monthly swelling of her knee. The complaints are associated with the menstrual cycle. After physical examination, radiographs, MRI and an arthroscopy with biopsies, a diagnosis of intra articular endometriosis and menstrual arthritis was made. DISCUSSION Both an intra articular manifestation of endometriosis and menstrual arthritis are very rare diagnoses. Extraperitoneal lesions of endometriosis are rare and the mechanism for spreading outside the retroperitoneal space is unknown. A similar situation exists for menstrual arthritis, it is thought that cytokines, which are produced as a reaction to retrograde menstruation, are the trigger for menstrual arthritis. A review of literature is given. CONCLUSION A monthly recurrent, painful swelling of a joint, can and should give rise to thorough investigation. Differential diagnostic one should think of intra articular manifestation of endometriosis and menstrual arthritis. We give a proposal for treatment.
The Knee