Causes of Bone/Joint Pain in Sickle Cell Disease Vaso-occlusive pain: • Mechanism: ischemic pain • Can present from infancy throughout life. • Generally affects long bones. • Repeat episodes predispose to other orthopedic complications. Avascular necrosis: • Affects 10% of patients w SCD. • Most common sites: hip, shoulder. • XR, MRI to dx and stage. • PEx limited diagnostically. Early dz difficult to see on XR. Osteomyelitis / Septic Arthritis: • Common d/t impaired splenic function -> think about encapsulated bugs. • Differentiate from vaso-occlusive pain w elevated CRP. • Hematogenous spread as source. - BWH Medicine Chiefs @BrighamChiefs #Bone #Joint #Pain #SickleCell #Disease #differential #diagnosis #causes #hematology
