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We report a case of a 63-year-old man with a history of monoarthritis, thought to have Rheumatoid Arthritis (RA) and treated with disease-modifying antirheumatic drugs (DMARDs). No clinical or serological improvement was observed. After five months synovectomy was performed. A foreign body was recovered, and synovial fluid analysis revealed a rare fungal infection, Phaeoacremonium sp. This is an educational case that reveals potential pitfalls of the specificity of using the current classification criteria for Rheumatoid Arthritis (RA) as a diagnostic tool in patients presenting with monoarthritis and highlights the need to continually reassess the diagnosis when there’s inadequate response to treatment. *Correspondence to: Alkhairi B, MD, Internal Medicine Resident, Blake Medical Center, Bradenton, Florida, USA, E-mail: baker.alkhairy@gmail.com

rheumatology and orthopedic medicine

The pitfalls of using the 2010 American college of rheumatology/European league against rheumatism (acr/eular) classification criteria for diagnosis of rheumatoid arthritis