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Leprosy-Induced Hip Arthritis: A Rare Case Report
Romit Agrawal1, Vijay Singh1, Ayush Sharma1
1Department of Orthopaedic Surgery, Dr. B.R Ambedkar Central Railway Hospital, Byculla, Mumbai, Maharashtra, India.
Journal of Orthopaedic Case Reports
|May 6, 2021
Summary
Leprosy can cause severe hip arthritis, sometimes mimicking rheumatoid arthritis. This case highlights a rare presentation of lepromatous hip arthritis treated successfully with a two-stage total hip arthroplasty.
Area of Science:
- Rheumatology
- Infectious Diseases
- Orthopedic Surgery
Background:
- Leprosy, a chronic granulomatous infection, typically manifests with skin and nerve issues.
- Joint involvement in leprosy can mimic rheumatoid arthritis, presenting as polyarthritis or tenosynovitis.
Observation:
- A 32-year-old male with known leprosy developed bilateral hip pain 9 months after diagnosis.
- Magnetic resonance imaging revealed bilateral avascular necrosis of the hip, progressing to arthritis in the left hip.
Findings:
- The patient underwent a two-stage total hip arthroplasty (THA) for advanced left hip arthritis.
- Post-surgery, the Harris hip score improved significantly from 35 to 91.5.
Implications:
- Leprosy can manifest with significant large joint involvement, including the hip.
- Two-stage THA offers a viable treatment for advanced leprosy-related hip arthritis in challenging cases.
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