Hypercholesterolemic (type II hyperlipoproteinemic) arthritis.

The rheumatic manifestations of familial hypercholesterolemia include recurrent Achilles pain or tendinitis, acute mono/oligoarthritis and migratory (rheumatic fever-like) polyarthritis. Diagnosis is made by finding skin and tendon xanthomas, hypercholesterolemia, and ruling out other rheumatic conditions such as rheumatic fever, gout, pseudogout and septic arthritis. A patient, homozygous for familial hypercholesterolemia, with a rheumatic fever-like migratory arthritis is presented.