Causes of Bone/Joint Pain in Sickle Cell Disease
• Mechanism: ischemic pain
• Can present from infancy throughout life.
• Generally affects long bones.
• Repeat episodes predispose to other orthopedic complications.
• Affects 10% of patients w SCD.
• Most common sites: hip, shoulder.
• XR, MRI to dx and stage.
• PEx limited diagnostically. Early dz difficult to see on XR.
Osteomyelitis / Septic Arthritis:
• Common d/t impaired splenic function -> think about encapsulated bugs.
• Differentiate from vaso-occlusive pain w elevated CRP.
• Hematogenous spread as source.
- BWH Medicine Chiefs @BrighamChiefs
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