Rheumatoid arthritis (RA) is an autoimmune disorder in which constitutional symptoms typically occur before joint swelling becomes a true clinical phenomenon. Weight loss, although common, is generally mild in nature and occurs after long standing inflammation. While large joints do become inflamed, RA has a much stronger predilection for the small joints. Our case is a rarity in the fact that there was initial large joint swelling without long standing inflammation. Additionally, the weight loss was cachectic in nature and extreme. Furthermore, while extra-articular manifestations do commonly occur, spontaneous pneumothorax is certainly atypical. The content of this manuscript serves to enlighten hospitalist physicians and residents, as to the odd way in which a case like this may present.
Weissman, S., Alsheikh, M., Kamar, K., Breslin, J., Khabut, A., & Maruf, M. (2018). Non-insidious Large Joint Manifestation of Severe Cachectic Rheumatoid Arthritis.. Cureus, 10 (9), e3266. https://doi.org/10.7759/cureus.3266
The original material can be found here: http://www.doi.org/10.7759/cureus.3266
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