Bilateral septic arthritis of the hips complicating the arthropathy of haemochromatosis

[Hip arthroplasty in genetic hemochromatosis. Report of 5 cases]

INTRODUCTION

Half of the patients with genetic hemochromatosis will have arthritis. Two of these articular involvements are well-known: the arthropathy involving the phalangeal and the metacarpophalangeal joints of the hand, useful for diagnosis, and hip arthropathy. Iron deposits seem to be involved in articular cartilage destruction.

EXEGESIS

We report five cases of patients with hemochromatosis hip involvement. Hip arthropathy revealed hemochromatosis in one case and appeared despite efficient phlebotomies in another case. Three of these patients required hip arthroplasty.

CONCLUSION

Hip arthropathy remains a frequent but unknown event in genetic hemochromatosis (12.5%) and it involves the functional prognosis.

Haemochromatosis

Arthropathy is a prominent but still underappreciated aspect of haemochromatosis. Clinical descriptions have characterized typical features, including involvement of the 2nd-3rd metacarpophalangeal joints with an osteoarthritic-like picture. Virtually any joint can be involved and can be a presenting clue to the underlying disease. The recent demonstration of the HFE gene on chromosome 6 with characteristic mutations should encourage further investigation. However, the pathogenesis of the arthropathy is not yet well understood. Treatment is also empirical and often unsatisfactory. Phlebotomies, although valuable to treat or prevent other features, do not predictably benefit the arthropathy.