Chronic massive knee effusion in familial Mediterranean fever.

OBJECTIVE: To document the occurrence of chronic massive knee effusions in patients with familial Mediterranean fever (FMF). PATIENTS: Three cases of chronic massive knee effusion of young FMF patients requiring open synovectomy are presented. RESULTS: Open synovectomy necessitated protracted rehabilitation, eventually with good results. CONCLUSIONS: FMF should be considered in the differential diagnosis of chronic massive knee effusion. Early diagnosis and daily colchicine treatment generally result in a good clinical outcome and may eliminate the need for open synovectomy in favor of arthroscopic surgery.

Total hip replacement in familial Mediterranean fever.

Familial Mediterranean fever (FMF) is a hereditary disorder affecting people of Mediterranean stock, mainly Sephardic Jews and Armenians. It is characterized by attacks of arthritis, either short, self-limited episodes typically lasting 72 hours or protracted attacks lasting from two weeks to one year. The latter form affects mainly the large joints of the lower limb. The hip joint is the most vulnerable and likely to be affected by the protracted attacks, which may result in destruction of the articular cartilage and, in some cases, aseptic necrosis of the femoral head. Eighteen FMF patients (19-52 years) underwent 22 total hip replacements between 1971 and 1985 at our hospital. Six of the 18 initial prostheses experienced aseptic loosening. This relatively high incidence led us to recommend implantation of cementless hip prostheses following meticulous synovectomy as the treatment of choice. The results of these surgeries and the uniqueness of total hip replacement in FMF patients are presented here and discussed.