Abstract
Background
Septic arthritis is a medical emergency because it can cause irreversible damage to joint cartilage and lead to serious complications and life-threatening consequences. So early diagnosis and proper treatment of septic arthritis are critical. But, the physician may miss other systemic diseases or misdiagnose the patient in the process leading to diagnosis.
Case presentation:
A 16-year-old female was admitted with myalgia-like shoulder pain. She had a history of injection on both shoulders, and she was complaining of inflammatory patterned pain. Unlike our suspicion of septic arthritis, MRI showed normal findings. However, we were able to finally diagnose myalgia accompanied by acute hepatitis caused by Epstein-Barr virus (EBV) through the laboratory findings. The patient underwent conservative treatment including fluid therapy, hepatotonics, and restriction of medications which cause hepatotoxicity. Shoulder pain improved gradually from the second day of treatment. Within one week, both symptoms and laboratory findings fully improved.
Conclusions
If a young adult patient has myalgia-like joint pain with an inflammatory sign, a detailed diagnostic approach is needed including thorough history taking and laboratory tests. Additionally, in the process of diagnosing septic arthritis, it is necessary to consider a differential diagnosis of viral infection as part of systemic symptoms such as EBV hepatitis.