Lead arthropathy and elevated serum levels of lead after a gunshot wound of the shoulder.

Farber, Jeffery; Rafii, Mahvash; Schwartz, David T.

doi:10.2214/ajr.162.2.8310931

Cited by 26 publications

(13 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Lead is highly soluble in the acid environment of synovial fluid and consequently, can expose the synovium and articular cartilage to elevated concentrations (Leonard, 1969). Blood lead levels of 30–62 μg/dL have been reported in patients with retained bullets (Farber et al, 1994; Gerhardsson et al, 2002). The findings in humans with lead fragments in and around a joint include 1) localized joint pain; 2) lead inclusion bodies in synoviocytes, articular chondrocytes and bone cells; 3) synovitis; 4) reduced joint space and range of motion; 5) degeneration of the articular surface; 6) chondrocalcinosis; and 7) synovial fibrosis.…”

Section: Leadmentioning

confidence: 98%

“…However, a musculoskeletal evaluation of the affected joints to diagnose arthritis was not performed. Nevertheless, there are dozens of reports in the literature in both humans and animals associating the genesis of a true osteoarthritis with lead exposure of a single joint due to the presence of a lead pellet or bullet fragment in the immediate vicinity of the joint (Switz et al, 1976; Windler et al, 1978; Dillman et al, 1979; Slavin et al, 1988; Crabill et al, 1994; Farber et al, 1994; Peh and Reinus, 1995). Lead is highly soluble in the acid environment of synovial fluid and consequently, can expose the synovium and articular cartilage to elevated concentrations (Leonard, 1969).…”

Section: Leadmentioning

confidence: 99%

See 1 more Smart Citation

Environmental agents affect skeletal growth and development

Holz

Sheu

Drissi

et al. 2007

Birth Defects Research Pt C

View full text Add to dashboard Cite

In this treatise we will examine complexities in the development and function of cells of the musculoskeletal system. Specifically, the role of chondrocytes and their ontogeny and osteoblasts and their ontogeny will be discussed as they regulate cartilage and bone formation. This background information will provide the foundation for evaluating the effects of environmental toxicants on skeletal development. A number of agents such as heavy metals (i.e. lead) and polycyclic aromatic hydrocarbons (i.e. pesticides and cigarette smoke) interact with cells of the skeletal system and adversely affect development. These agents have not been of major research interest, nevertheless, given changes in the environmental profile of the United States and other developed countries, it is important that we understand their effects in bone and cartilage. Research in this area will identify strategies that may be used to help prevent musculoskeletal diseases due to toxicant exposure.

show abstract

Section: Leadmentioning

confidence: 98%

Section: Leadmentioning

confidence: 99%

Environmental agents affect skeletal growth and development

Holz

Sheu

Drissi

et al. 2007

Birth Defects Research Pt C

View full text Add to dashboard Cite

show abstract

“…In addition, the exposure of a bullet to synovial fluid may lead to dissolution of the leaded fragments due to the presence of hyaluronic acid and the low pH of synovial fluid. [7][8][9][10] The effects of gunshot injury to other joints have been known to cause lead toxicity and synovitis. Although leaving the bullet and ballistic fragments intact is the current recommendation, this subject has not been recently revisited.…”

Section: E1552mentioning

confidence: 99%

Posttraumatic Arthritis From Gunshot Injuries to the Hip Requiring a Primary THA

Naziri

Issa

Rizkala³

et al. 2013

Orthopedics

View full text Add to dashboard Cite

Gunshot injuries to the hip can be devastating, leading to posttraumatic arthritis and presenting a surgical challenge at the time of total hip arthroplasty (THA) due to the presence of metallic fragments and damaged soft tissues. However, there are few reports of gunshot-related posttraumatic arthritis. The purpose of this study was to describe the features and report the early outcomes of THA in 4 patients who developed posttraumatic arthritis from gunshot injuries to their hips 2, 10, 18, and 26 years after their initial injury, respectively. All 4 patients underwent successful THA without complications. None of the patients had undergone a revision procedure at a mean 26-month (range, 12-48 months) follow-up. The authors believe that primary THA is a safe and effective procedure to reduce pain and improve function for gunshot-related posttraumatic arthritis in patients in whom nonoperative management failed.

show abstract

“…Exposure of a bullet to synovial uid may lead to dissolution of the leaded fragments due to the presence of hyaluronic acid and the low pH of synovial uid. Thus, patients with intraarticular fragments require removal because they may lead to mechanical abrasion and joint destruction [12,15,[16][17][18][19].…”

Section: Discussionmentioning

confidence: 99%

Treatment of Secondary Hip Arthritis from Shell Fragment and Gunshot Injury in the Syrian Civil War

Özden¹,

Davut

Doğramacı

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: In gunshot and shell fragment injuries to the hip joint, orthopaedic intervention includes wound assessment and care, osteosynthesis of fractures, and avoiding of infection and osteoarthritis. The aim of this study was to evaluate the outcomes of the patients with secondary hip arthritis due to prior gunshot and shell fragment (shrapnel) injuries who underwent primary total hip arthroplasty. Methods: This retrospective study reviewed 26 patients (24 males, 2 females) who underwent hip arthroplasty due to prior gunshot and shell fragment injuries from November 2013 to January 2019. For all patients Harris Hip Score (HHS) were evaluated preoperatively and after surgery. Results: Mean age was 31,5 (range, 19-48) years. The mean preoperative HHS was 52.95 points and the mean postoperative HHS was 79.92 points at the final follow-up after surgery. Patients with shell fragment injuries to the hip joint, had higher infection rates but it is not statistically significant.Conclusions: An anatomic reduction of the fracture may not be possible in these cases as a result of significant bone and/or cartilage loss. Total hip arthroplasty can be done after gunshot and shell fragment related posttraumatic arthritis. It is efective treatment choice to reduce pain and improve function but the surgeon must be very carefull because of high rate of infection.

show abstract

Lead arthropathy and elevated serum levels of lead after a gunshot wound of the shoulder.

Cited by 26 publications

References 4 publications

Environmental agents affect skeletal growth and development

Environmental agents affect skeletal growth and development

Posttraumatic Arthritis From Gunshot Injuries to the Hip Requiring a Primary THA

Treatment of Secondary Hip Arthritis from Shell Fragment and Gunshot Injury in the Syrian Civil War

Contact Info

Product

Resources

About