Analysis of 16 teenage patients with sickle cell anemia and musculoskeletal complications

Background: Sickle cell anemia is a genetic hematological disorder characterized by red blood cell abnormalities including rigidity and sickling. Once a sufficient number of rigid sickle cells are formed, microvascular occlusion would result that leads to tissue ischemia and infarction and progressive end organ damage. Aim: The aim of this study was to analyze 16 teenage patients with sickle cell disease to determine the pattern of musculoskeletal complications during 2 years. Materials and Methods: This is a retrospective study of cases of musculoskeletal complications among sickle cell anemic patients who referred to the rheumatologic clinic of Mazandaran University of Medical Sciences from January 2010 to December 2012 (during a 2-year period). Data were analyzed using the SPSS version 20. Variables analyzed included age, sex, and kind of musculoskeletal complications. Results: There were 16 sickle cell patients referring to our rheumatologic clinic for musculoskeletal complications during the study period. All were teenage patients, aged between 12 and 17 years, with a median age of 14.6 years. Twelve patients were male and four patients were female. The most common musculoskeletal complications were: Acute painful crisis in 10 (62.5%), osteomyelitis in 3 (18.5%), dactilitis in 4 (25%), avascular necrosis of bones in 6 (37.5%), stress fractures and vertebral collapse in 2 (12.5%), septic arthritis in 1 (0.6%) patient, and hyperuricemia/gout arthritis in 3 (18.5%) patients. Conclusion: Serious musculoskeletal complications of sickle cell anemia are very important and must be considered in these patients. Painful crisis and avascular necrosis of bones are the common rheumatologic complications of this disorder.