{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T12:44:10Z","timestamp":1784205850472,"version":"3.55.0"},"reference-count":8,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,5,10]],"date-time":"2024-05-10T00:00:00Z","timestamp":1715299200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,5,10]],"date-time":"2024-05-10T00:00:00Z","timestamp":1715299200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Med Case Reports"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Introduction<\/jats:title>\n                <jats:p>Although viscosupplementation is a commonly used treatment for osteoarthritis and is widely regarded as a safe treatment option, it is associated with the rare complication of pseudoseptic arthritis. Most existing case reports that cite this rare complication employed the use of early broad-spectrum antibiotics.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>In this case report, we present a 61-year-old African American female patient who presented with bilateral knee pseudoseptic arthritis in the setting of viscosupplementation. She presented 3\u00a0days after bilateral viscosupplementation injections with bilateral knee swelling, discomfort, and pain with micromotion. Her white blood cell count (WBC) was 12.83 (4.5\u201311 normal), her C-reactive protein (CRP) level was 159\u00a0mg\/L (0\u201310 normal), and her erythrocyte sedimentation rate (ESR) was 79\u00a0mm\/hour (0\u201340 normal). Her left knee aspirate yielded 38,580 WBC with a negative gram stain and negative cultures. Her right knee aspirate yielded 29,670 WBC with a negative gram stain and negative cultures. Through the utilization of careful clinical monitoring, ice therapy, and non-steroidal inflammatory medication, we were able to successfully treat this patient while maintaining proper antibiotic stewardship.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Pseudoseptic arthritis in the setting of viscosupplementation can be adequately treated and monitored without the use of antibiotics.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13256-024-04568-2","type":"journal-article","created":{"date-parts":[[2024,5,10]],"date-time":"2024-05-10T00:02:04Z","timestamp":1715299324000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Demonstrating antibiotic stewardship while diagnosing and treating bilateral pseudoseptic arthritis: a case report"],"prefix":"10.1186","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7700-5641","authenticated-orcid":false,"given":"Rae","family":"Tarapore","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sierra","family":"Lindsey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paige","family":"Strickland","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"McKinstry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,5,10]]},"reference":[{"key":"4568_CR1","first-page":"44","volume":"12","author":"Z Idrissi","year":"2012","unstructured":"Idrissi Z, Benbouazza K, Fourtassi M, Raissouni H, El Aadmi M, Zanat F, Hajjaj-Hassouni N. Acute pseudo-septic arthritis following viscosupplementation of the knee. Pan Afr Med J. 2012;12:44.","journal-title":"Pan Afr Med J"},{"issue":"1","key":"4568_CR2","doi-asserted-by":"publisher","first-page":"59","DOI":"10.5152\/eurjrheum.2016.15075","volume":"4","author":"M Ayd\u0131n","year":"2017","unstructured":"Ayd\u0131n M, Ar\u0131kan M, To\u011fral G, Var\u0131\u015f O, Ayd\u0131n G. Viscosupplementation of the knee: three cases of acute pseudoseptic arthritis with painful and irritating complications and a literature review. Eur J Rheumatol. 2017;4(1):59\u201362. https:\/\/doi.org\/10.5152\/eurjrheum.2016.15075.","journal-title":"Eur J Rheumatol"},{"key":"4568_CR3","doi-asserted-by":"publisher","first-page":"130","DOI":"10.1097\/00003086-200402000-00021","volume":"419","author":"VM Goldberg","year":"2004","unstructured":"Goldberg VM, Coutts RD. Pseudoseptic reactions to hylan viscosupplementation: diagnosis and treatment. Clin Orthop Relat Res. 2004;419:130\u20137. https:\/\/doi.org\/10.1097\/00003086-200402000-00021.","journal-title":"Clin Orthop Relat Res"},{"issue":"2","key":"4568_CR4","doi-asserted-by":"publisher","first-page":"25549","DOI":"10.52965\/001c.25549","volume":"13","author":"J Peck","year":"2021","unstructured":"Peck J, Slovek A, Miro P, Vij N, Traube B, Lee C, Berger AA, Kassem H, Kaye AD, Sherman WF, Abd-Elsayed A. a comprehensive review of viscosupplementation in osteoarthritis of the knee. Orthop Rev. 2021;13(2):25549. https:\/\/doi.org\/10.52965\/001c.25549.","journal-title":"Orthop Rev"},{"issue":"4","key":"4568_CR5","doi-asserted-by":"publisher","first-page":"978","DOI":"10.1002\/1529-0131(200104)44:4<978","volume":"44","author":"PB Martens","year":"2001","unstructured":"Martens PB. Bilateral symmetric inflammatory reaction to hylan G-F 20 injection. Arthritis Rheum. 2001;44(4):978\u20139. https:\/\/doi.org\/10.1002\/1529-0131(200104)44:4%3c978.","journal-title":"Arthritis Rheum"},{"issue":"7","key":"4568_CR6","first-page":"1311","volume":"22","author":"MP Puttick","year":"1995","unstructured":"Puttick MP, Wade JP, Chalmers A, Connell DG, Rangno KK. Acute local reactions after intraarticular hylan for osteoarthritis of the knee. J Rheumatol. 1995;22(7):1311\u20134.","journal-title":"J Rheumatol"},{"issue":"4","key":"4568_CR7","doi-asserted-by":"publisher","first-page":"352","DOI":"10.1016\/j.jbspin.2003.09.001","volume":"71","author":"J Roos","year":"2004","unstructured":"Roos J, Epaulard O, Juvin R, Chen C, Pavese P, Brion JP. Acute pseudoseptic arthritis after intraarticular sodium hyaluronan. Joint Bone Spine. 2004;71(4):352\u20134. https:\/\/doi.org\/10.1016\/j.jbspin.2003.09.001.","journal-title":"Joint Bone Spine"},{"key":"4568_CR8","doi-asserted-by":"publisher","unstructured":"Massey PA, Clark MD, Walt JS, Feibel BM, Robichaux-Edwards LR, Barton RS. 2021. Optimal synovial fluid leukocyte count cutoff for diagnosing native joint septic arthritis after antibiotics: a receiver operating characteristic analysis of accuracy. J Am Acad Orthopaedic Surgeons. 29(23):p e1246-e1253, https:\/\/doi.org\/10.5435\/JAAOS-D-20-01152","DOI":"10.5435\/JAAOS-D-20-01152"}],"container-title":["Journal of Medical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13256-024-04568-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13256-024-04568-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13256-024-04568-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,10]],"date-time":"2024-05-10T00:02:19Z","timestamp":1715299339000},"score":1,"resource":{"primary":{"URL":"https:\/\/jmedicalcasereports.biomedcentral.com\/articles\/10.1186\/s13256-024-04568-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,10]]},"references-count":8,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["4568"],"URL":"https:\/\/doi.org\/10.1186\/s13256-024-04568-2","relation":{},"ISSN":["1752-1947"],"issn-type":[{"value":"1752-1947","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,10]]},"assertion":[{"value":"4 April 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 April 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 May 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient for publication of this case report and any accompanying images.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"242"}}