title: Lead arthropathy: a cause of delayed onset lead poisoning.
abstract: Patients who suffer gun shot wounds often have retained bullet fragments within their bodies. These are usually of no clinical consequence. We describe three patients with retained bullets within their hip joints. One of these patients, who had extensive ground intra-articular bullet fragments and secondary osteoarthritis of the hip, presented with signs, symptoms, and laboratory data consistent with lead intoxication. The bullet and metallic fragments were removed surgically with good clinical response. Two patients whose bullets were implanted entirely within the femoral head and whose joints showed smaller degrees of lead fragmentation had no symptoms of lead intoxication. The degree of intra-articular fragmentation of the bullet and the surface area of lead exposed to synovial fluid are emphasized as decisive factors with respect to appropriate therapy.
authors.affiliation: Department of Diagnostic Radiology, University of Hong Kong, Queen Mary Hospital.
authors.forename: W C
authors.initials: WC
authors.lastname: Peh
authors.forename: W R
authors.initials: WR
authors.lastname: Reinus
mesh_terms: D000368:Aged; D005260:Female; D005270:Femur Head / Q000293:injuries; D005547:Foreign Bodies / Q000150:complications* / Q000000981:diagnostic imaging; D025981:Hip Injuries; D006621:Hip Joint; D006801:Humans; D007855:Lead Poisoning / Q000209:etiology*; D008297:Male; D015207:Osteoarthritis, Hip / Q000000981:diagnostic imaging / Q000209:etiology; D011859:Radiography; D013997:Time Factors; D014948:Wounds, Gunshot / Q000150:complications* / Q000000981:diagnostic imaging