Arthritis: Miscellaneous Causes

• Kashin-Bek disease. Aetiology is unknown. The disease occurs in certain areas of Asia and appears as a chronic osteoarthritis.

• Haemoglobinopathy, such as in sickle cell patients. Hip joint necrosis, shoulder destruction and hand-foot syndrome (dactylitis) are frequent in homozygotic children. Osteomyelitis is a frequent complication.

• Chronic hip lesions in children may be due to congenital abnormalities such as congenital hip dislocation, subluxation or congenital syphilis, in addition to tuberculosis and sickle cell disease. In Calvé-Legg-Perthes disease there is a usually unilateral necrosis of the femoral epiphysis, as a result of ischaemia (aseptic necrosis).

• Trauma, both acute and chronic. A fracture can sometimes not be noticed at first. Avascular necrosis can follow (head of femur, wrist).

• Psoriasis can be accompanied by articular inflammation. Check skin and nails.

• Congenital diseases such as Gaucher’s disease. There is a form of this disease that occurs in young people, but also one that becomes apparent only in adults. Chronic splenomegaly is usually a feature of this metabolic disease. The hip joint is frequently affected.

Category: Medicine Notes