title: The shoulder in sickle-cell disease.
abstract: Sickle-cell disease (SCD) is probably the commonest cause of avascular necrosis worldwide, and its prevalence appears to be rising in developed countries. Avascular necrosis of the humeral head is a common complication but has not been previously studied in detail. We have reviewed 138 patients with SCD for clinical, radiological and functional abnormalities of the shoulder, using a radiological classification designed for avascular necrosis of the shoulder. Radiographic lesions, frequently bilateral, were found in 28% and only 53% of patients had normal shoulder function. The management of this relatively common complication is difficult. Joint replacement is likely to fail and early diagnosis is important.
authors.affiliation: Central Middlesex Hospital, London, England.
authors.forename: H G
authors.initials: HG
authors.lastname: David
authors.forename: S A
authors.initials: SA
authors.lastname: Bridgman
authors.forename: S C
authors.initials: SC
authors.lastname: Davies
authors.forename: A L
authors.initials: AL
authors.lastname: Hine
authors.forename: R J
authors.initials: RJ
authors.lastname: Emery
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D006450:Hemoglobin SC Disease / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D006811:Humerus / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D010020:Osteonecrosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology; D011859:Radiography; D012785:Shoulder Joint / Q000000981:diagnostic imaging* / Q000503:physiopathology