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Arthropathy in Sickle-Cell Disease

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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.

▸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.

Philadelphia, Pennsylvania

Ann Intern Med. 1973;78(2):203-211. doi:10.7326/0003-4819-78-2-203
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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.





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