Multiple rheumatoid bursitis with migrating chylous cysts - Report of a case in a European woman and review of the literature

We report a case of recurrent multiple bursitis (19 episodes at nine sites) requiring seven surgical procedures in a European woman with a 38-year his tory of severe, nodular, destructive seropositive rheumatoid arthritis unre sponsive to second-line drugs. The episodes of bursitis were not correlated with activity of the joint disease. Some cysts migrated over a considerabl e distance. At least two cysts contained chylous fluid. The histologic stud y of one cyst demonstrated a cholesterol crystal granuloma. Potential relat ionships linking cholesterol crystals, chylous cysts, and migrating multipl e bursitis are discussed. The relevant Literature is reviewed.