Case 264

Medical History

A 22-year-old female patient presented incapacitating asymmetric polyarthralgia in the ankles, left hip joint, wrist and knee, accompanied by phlogistic signs, with sudden onset 1 month ago. There is no report of fever, but is in use of antibiotic therapy for 7 days for treatment of sacral ulcer. Report of untreated vaginal discharge in the month prior to the pain, with the partner diagnosed with gonorrhea. Carrier of Systemic Lupus Erythematosus (SLE), without corticotherapy for 5 months. The patient was admitted to the hospital, joint punctures (with negative cultures) and imaging were performed for the extension of the propaedeutic (attachments).

Based on the clinical data and imaging tests, what is the most likely diagnosis?

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