LAUSR

In malignant and rheumatological diseases, there is often an overlap of signs and symptoms that requires that neoplasms be considered as a differential diagnosis. We report the case of a 22-year-old female admitted to the emergency department with a 4 week history of fever and right thigh inflammatory pain, refractory to non-steroidal anti-inflammatory drugs (NSAIDs). No previous musculoskeletal symptoms were reported and her past medical history was unremarkable. On physical examination, she presented with fever (axillar tempera-ture of 38.7°C) and intense pain with marked limitation in the mobilization of the right hip joint in all ranges of motion. Multiple swollen and painless lymph nodes (submandibular, cervical, and axillary regions) were noted, as was a new 3 cm painless mass on the dorsum of the nose. Laboratory work-up revealed normochro-mic normocytic anaemia [8.8 g/dL (normal value > 12.5 g/dL)], hyperferritinaemia [1502 ng/mL (normal range 10–291 ng/mL)], and elevation of acute-phase reactants [erythrocyte sedimentation rate 54 mm/h (nor-mal value < 20 mm/h) and C-reactive protein [8.74 mg/ dL (normal value < 0.5 mg/dL)]. Results of screening for human immunodeficiency virus, hepatitis B and C, Epstein–Barr virus, and cytomegalovirus were negative, as was an autoimmunity panel (rheumatoid factor, anti-cyclic citrullinated peptide, and antinuclear antibodies). Blood and urine