Musculoskeletal disorders associated with HIV infection and AIDS. Part I: Infectious musculoskeletal conditions

Abstract

The musculoskeletal system can be affected by a variety of abnormalities in association with human immunodeficiency virus (HIV) infection. Although not as common as complications involving other organ systems, such as the pulmonary and the central nervous systems, HIV-associated musculoskeletal disorders are sometimes the initial presentation of the viral illness. Knowledge of the existence and the characteristic appearance of the conditions affecting bone, joint, and muscle in HIV-infected patients is valuable to radiologists for diagnosis and to clinicians for detection and appropriate treatment. We reviewed recent literature to provide a comprehensive assessment of the HIV-associated musculoskeletal disorders, and present radiologic examples from our own collection. This article is divided into two parts. In the first part we review the infectious musculoskeletal disorders associated with HIV illness and AIDS, including cellulitis, abscesses, pyomyositis, septic bursitis, septic arthritis, osteomyelitis, and bacillary angiomatosis. We also present a comprehensive spectrum of mycobacterial infections, consisting of tuberculous spondylitis and spondylodiskitis, arthritis, osteomyelitis, and tenosynovitis, as well as infections caused by atypical mycobacteria. Part II of this review will concentrate on non-infectious musculoskeletal conditions, including rheumatic disorders and neoplasms.

Tuberculous Pyomyositis of Forearm Muscles

“…Tuberculous pyomyositis is typically caused by invasion from adjacent structures rather than by primary infection, lymphatic spread, or hematogenous seeding [2]. The diagnosis of tuberculous pyomyositis is more common in immunodeficient patients and associated with the use of corticosteroids, the presence of HIV infection, the administration of cancer chemotherapy, and renal failure [2,6,10,14,16,20,24]. Tuberculous pyomyositis can develop in immunocompetent persons, with the common symptoms of evening rise of temperature, night sweats, malaise, loss of appetite, and weight loss [18].…”

Musculoskeletal Infections in Human Immunodeficiency Virus

“…Bones, as well as joints or striated muscle [5][6][7][8] can be affected. Infections may affect peripheral joints, spine, long bones or muscles.…”

HIV Infection: Implications on Surgical Practice

“…Tuberculous infections may likewise involve soft tissue or bones/joints (Tehranzadeh et al, 2004). While it may be expected that HIV infection would lead to an increase in musculoskeletal infections, some studies have indicated that this may not be so (Bahebeck et al, 2004).…”