Immobile to Ambulation: Complex Multijoint Pathologies in a Patient with Advanced HIV Disease: A Case Report.

Q4 Medicine JBJS case connector Pub Date : 2024-09-13 eCollection Date: 2024-07-01 DOI:10.2106/JBJS.CC.24.00025
Justin T Samuel, Imani N Nwokeji, Sehrish Ali, Nityananda Rao Jakkula, Jonathan Fung, Andrew Campbell, Naveen Singanamala
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Abstract

Case: A 30-year-old man with a history of advanced HIV disease (AHD) presented with bilateral equinocavus, leg, and foot muscle paresis, Brooker grade 4 heterotopic ossification of hips and knee stiffness, and was unable to sit upright, stand independently, or walk. Electromyography showed demyelinating sensorimotor and axonal polyneuropathy of lower extremities. Multiple surgeries of bilateral hips, ankles, and feet enabled joint mobility, plantigrade feet, and independent ambulation.

Conclusion: Patients with AHD may develop multijoint pathologies, secondary to HIV, antiretroviral therapy, or prolonged immobility, resulting in loss of ambulation and independence. Restoring ambulation may necessitate multiple surgeries, with potential for success.

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从行动不便到行动自如:晚期艾滋病患者的复杂多关节病变:病例报告。
病例:一名患有晚期艾滋病(AHD)的 30 岁男子出现双侧马蹄内翻症、腿部和足部肌肉瘫痪、髋部布罗克 4 级异位骨化和膝关节僵硬,无法直立坐起、独立站立或行走。肌电图显示,下肢出现脱髓鞘性感觉运动和轴索性多发性神经病。经过对双侧髋关节、脚踝和双脚进行多次手术后,患者的关节可以活动,双脚可以站立,并能独立行走:结论:由于艾滋病病毒、抗逆转录病毒治疗或长期静止不动,AHD患者可能会出现多关节病变,从而丧失行走能力和独立性。恢复行动能力可能需要多次手术,但也有成功的可能。
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来源期刊
JBJS case connector
JBJS case connector Medicine-Medicine (all)
CiteScore
0.60
自引率
0.00%
发文量
319
期刊介绍: JBJS Case Connector helps improve patient care by providing the medical community with a journal that harnesses technology to provide information tools for discovery and reporting of unusual musculoskeletal problems, findings, treatment, and outcomes. Co-edited by Thomas W. Bauer, MD, PhD, and Ronald W. Lindsey, MD, JBJS Case Connector assists orthopaedic surgeons in the search for precedents, connections, and trends in their efforts to improve patient care. Using this unique journal, surgeons can find the commonalities between cases, benefit from the experience of their peers, and filter case information by many important variables in order to provide the best possible care for orthopaedic patients. This cross-referenced online journal includes thousands of orthopaedic case reports. It compiles symptoms, conditions, and demographic details to empower surgeons to find cases similar to theirs. Surgeons can mine the database to reveal emerging trends and identify patterns, distinguishing between truly rare cases and repeated, related single instances of a larger problem. The JBJS Case Connector Image Quiz feature provides interactive quizzes based on images from content published by JBJS and includes a discussion area for further exploration of ideas and concepts. The JBJS Image Quiz app for iPad and iPhone is available in the App Store. Contributions to JBJS Case Connector are welcomed from anywhere in the world and are considered on their merits. Articles must be written in English and should be submitted as outlined in the Instructions to Authors. All authors must abide by the JBJS ethics policies and all submissions to JBJS Case Connector are covered by the JBJS embargo policy.
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