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We prospectively studied 20 Saudi and Yamani patients with calcified guinea worm who presented with different rheumatic manifestations. Localized myalgia (55%), chronic monoarthralgia (35%) and chronic synovitis of the knee (10%) were the main presentations. Two cases with synovial fluid eosinophilia were seen. In spite of the absence of active infestation, the clinical, laboratory and radiological findings suggested the possibility of a causal relationship. The condition should be considered among other causes of parasitic rheumatism particularly in endemic areas.