A Strange Evolution of Rheumatoid Arthritis – Case Report

Abstract

This paper brings in discussion a strange case evolution of rheumatoid arthritis in a female patient of 72 years old who was admitted in the Department of Plastic Surgery and Reconstructive Microsurgery for a tumoral structure of 4/8 cm in the right deltoid region, with incision marks on its surface, non-adherent with the surrounding tissues and no inflammatory sign locally. The patient has a history of more than 20 year of rheumatoid arthritis, for whom she had been treated whit immunosuppressors (Etanercept) for 10 years. Taking in consideration this fact, the most significant side effect of these medications is the increasing risk of all types of infections, including tuberculosis, especially skin tuberculosis or even an abscess due to a possible local skin reactions after injection of the anti-TNF agent. The deltoid region presented skin incisions, drainage and unsuccessful multiple antibiotic therapy, which led us to question marks regarding the origin of the collection. Rheumatoid involvement of the shoulder seems to be relatively not so common as the involvement of peripheral joints, but painful symptoms in this region are present.