After cutaneous and neurological manifestations, bone and joint involvement are the most common manifestations in Hansen’s disease (HD). Sometimes, these are undiagnosed and rarely reported.

A 68-year-old Filipino, male, presented with an 8-month history of digital joint swelling on both hands. He was initially managed by Rheumatology for arthritis, partially responsive to Methotrexate and Prednisone. Immunology and lupus panel tests were unremarkable. Skin biopsy done on a solitary erythematous plaque on the back revealed granulomatous dermatitis, tuberculoid type. Fite-Faraco, AFB, PAS stains were negative. Four weeks later, he developed multiple erythematous papules and plaques on the face, ears, lower back, gluteal area, and lower extremities. Arthritis was persistent but hypoesthesia, hypohidrosis or alopecia were not reported. A repeat skin biopsy showed epithelioid to macrophagic cell granulomatous reaction compatible to HD. AFB stain and slit skin smear were positive. He was managed as a case of Borderline (BB) to Borderline Lepromatous (BL) leprosy and was started on multibacillary drug treatment (MDT) of Rifampicin, Clofazimine and Dapsone. One month later, the patient reported resolution of skin lesions and arthritis.

Approximately 75% of individuals with HD experience arthritis, which can be one of the early signs of disease. A high index of suspicion is required as it closely mimics other rheumatologic conditions.

Human ; Male ; Aged: 65-79 Yrs Old ; Arthritis ; Rheumatology

STUDY DESIGN: Compare the effectiveness of three types of cages used in each case separately with that of cages supplemented by posterior fixation such as transfacet screws and transpedicular screws. OBJECTIVES: To determine whether any important information could be obtained when anterolateral and/or posterolateral bending is imposed. SUMMARY OF LITERATURE REVIEW: Most lumbar spine biomechanical bending tests have been performed on flexion-extension and lateral bending only. MATERIALS AND METHODS: Flexibility was tested through the unconstrained eccentric compression-bending of isolated L4-L5 motion segments. A total of sixteen fresh frozen human cadaveric lumbosacral spine specimens(range of ages : 42+/-13 years 12 males and 4 females) were tested in this investigation. In each case bending load was applied in flexion(0 degree direction), then in 30 degree increments around the transverse plane until flexion was repeated at the 360 degree loading direction. Specimens underwent anterior interbody instrumentation with three different types of cage at L4-5 in three groups, respectively. After testing the interbody fusion constructs, the L4-L5 segments were first stabilized posteriorly using transfacet screws and then retested using transpedicular screw instrumentation. RESULTS: In the intact model, the increase in deflection angle was twice compared with that of the previous point starting from 120 degree up to 150 degree. The pure extensional motion showed the largest deflection angles which are 3.5 times higher than those in pure flexion in average. All three types of cages showed the similar results that were obtained from the intact model.
Cadaver ; Humans ; Male ; Pliability ; Spine