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Arthropathy in Sickle-Cell Disease
- H. RALPH SCHUMACHER, M.D.;
- RONALD ANDREWS, M.D.; and
- GEORGE McLAUGHLIN, M.D.
Abstract
Individuals with sickle-cell disease may develop gout, septic arthritis, osteomyelitis, aseptic osteonecrosis, and possibly hemarthrosis. Other patients have only arthralgia or joint effusions. These effusions, studied here for the first time, are "noninflammatory," despite the frequent acute onset, warmth, and tenderness that might clinically suggest other types of arthritis. Joint effusions most often occurred with other evidences of painful crises. Synovial biopsies in five patients, aged 6 to 29 years, showed microvascular thrombosis that, along with vascular occlusion in adjacent tissues, may be the mechanism for the effusions. Sickled erythrocytes in effusions can suggest sickle-cell arthropathy. Adjacent bones may show evidence of previous infarctions.
Article and Author Information
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▸From the Veterans Administration Hospital; Hospital of the University of Pennsylvania; Philadelphia General Hospital; and Germantown Hospital; Philadelphia, Pa.
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Supported in part by grants from the Veterans Administration, Washington, D.C.; the Barsumian Memorial Fund, Philadelphia, Pa.; and grant 5Molrr40, Clinical Research Center, National Institutes of Health, Bethesda, Md.
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▸Requests for reprints should be addressed to H. Ralph Schumacher, M.D., Director, Arthritis Research, Veterans Administration Hospital, University and Woodland Avenues, Philadelphia, Pa. 19104.
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- Received August 14, 1972.
- Accepted October 30, 1972.
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