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A 43-year-old woman presented to the emergency department in a rural South African hospital with knee pain following a fall. Her medical history included epilepsy, for which she took phenytoin. Examination of the knee revealed joint swelling and tenderness; the range of motion was from 20° to 90° limited by pain, but there was no neurovascular compromise. Concomitantly, numerous firm subcutaneous nodules were noted. Lateral and anteroposterior radiographs of the knee ( figures 1 A, B, respectively) revealed multiple, small, calcified nodules longitudinally aligned with the muscle fibres of the posterior compartment of the thigh and calf. Full blood count, urea and electrolytes, calcium and liver function tests were unremarkable; however, cysticercosis serology was positive.
Cysticercosis is due to the tapeworm, Taenia solium. It is endemic in...