Most of the orthopedists use intraarticular supplementation of hyaluronic acid to relieve osteoarthritis ´pain. Usually this treatment is safe but, sometimes it has some adverse events that should be known, as the pseudoseptic reaction or severe acute inflammatory reaction. We present a 48 years old man that presented fever and inflammatory reaction in his ankle after the second intraarticular injection of hyaluronate. An ankle arthrotomy was performed, but the culture results were negative. Discusion: We may consider the difference between this reaction and a real septic disease, that requires antibioterapy and, in most cases, surgery. Otherwise, the pseudoseptic reaction improves with rest and anti-inflammatory drugs, and does not suppose a damage to the cartilage.

Most of the orthopedists use intraarticular supplementation of hyaluronic acid to relieve osteoarthritis ´pain. Usually this treatment is safe but, sometimes it has some adverse events that should be known, as the pseudoseptic reaction or severe acute inflammatory reaction. We present a 48 years old man that presented fever and inflammatory reaction in his ankle after the second intraarticular injection of hyaluronate. An ankle arthrotomy was performed, but the culture results were negative. Discusion: We may consider the difference between this reaction and a real septic disease, that requires antibioterapy and, in most cases, surgery. Otherwise, the pseudoseptic reaction improves with rest and anti-inflammatory drugs, and does not suppose a damage to the cartilage.