Effusion of the Hips in a Patient With Tetraplegia

Abstract

Background: Patients with spinal cord injury are at risk for knee effusion, most likely as a result of repetitive microtrauma. Patients with paralysis are susceptible to effusions of the hip similar to those seen in documented cases regarding the knee. The etiology is likely similar and is related to repetitive microtrauma, such as that experienced when aggressive range of motion exercises are applied.Design: Case report.Setting: Acute rehabilitation department of a spinal cord injury center.Findings: A 19-year-old man with a complete cervical spinal cord injury presented to acute rehabilitation on postinjury day 25 with a C6 American Spinal Injury Association classification A injury, complete. He was found to have bilateral hip effusions. Joint aspiration yielded a right sterile hydroarthrosis and a left sterile hemarthrosis. During his rehabilitation stay, the patient developed one mildly elevated alkaline phosphatase level, but he showed no radiographic evidence of heterotopic ossification and maintained full passive range of motion of the hips.Conclusion: This case indicates that hip effusion may be a similar, less-common occurrence than knee effusion in patients with spinal cord injury. In this case, bilateral aseptic hip effusion was not associated with heterotopic ossification. More research is needed to determine the etiology and sequelae of this condition.

Inflammatory Sacroiliitis in a Man With Spinal Cord Injury

“…Degenerative joint abnormalities of hips, shoulders, symphysis pubis, and the axial skeletal changes involving sacroiliac joints may develop years after the SCI (3)(4)(5)(6). However, we did not find reports of sacroiliac joint problems during early SCI in the literature.…”

Neuroarthropathy of the hip following spinal cord injury

“…Knee effusions and, less commonly, hip joint effusions and heterotopic ossification have been noted by different authors in the setting of SCI. 6 Repetitive microtrauma has been implicated in the etiology but the significance of such a finding and whether it precedes heterotopic ossification and possibly arthropathy is still unclear.…”

“…Charcot’s neuroarthopathy is a well-recognized entity in the setting of absent sensation in the foot, spine, shoulder, wrist, knee and other joints 1–6. It is a challenging problem to treat because of its chronicity and its indolent nature.…”

“…Charcot’s neuroarthopathy is a well-recognized entity in the setting of absent sensation in the foot, spine, shoulder, wrist, knee and other joints. 1 – 6 It is a challenging problem to treat because of its chronicity and its indolent nature. Even though a well-recognized possibility, to the best of our knowledge, there has been no report in the English literature on the isolated involvement of a hip joint by Charcot’s neuroarthropathy in a patient with spinal cord injury.We present the case of a young man with spinal cord injury who developed a neuroarthropathic right hip that lead to a massive swelling, impending decubitus ulcer and difficulty in transferring and ambulation in a wheelchair.…”

Beyond broken spines–what the radiologist needs to know about late complications of spinal cord injury

“…It has been hypothesised that paralysed muscles result in joint laxity thereby allowing for joint fluid accumulation [ 50 ]. Others contend that repetitive microtrauma, such as encountered in aggressive range of motion exercises, may be the aetiology [ 51 , 52 ]. However, SCI patients may develop joint effusions of any cause, infectious, inflammatory, traumatic or benign.…”