Effusion of the hips in a patient with tetraplegia.
BACKGROUND
Patients with spinal cord injury are at risk for knee effusion, most likely as a result of repetitive microtrauma. Patients with paralysis are susceptible to effusions of the hip similar to those seen in documented cases regarding the knee. The etiology is likely similar and is related to repetitive microtrauma, such as that experienced when aggressive range of motion exercises are applied.


METHODS
Case report.


METHODS
Acute rehabilitation department of a spinal cord injury center.


RESULTS
A 19-year-old man with a complete cervical spinal cord injury presented to acute rehabilitation on postinjury day 25 with a C6 American Spinal Injury Association classification A injury, complete. He was found to have bilateral hip effusions. Joint aspiration yielded a right sterile hydroarthrosis and a left sterile hemarthrosis. During his rehabilitation stay, the patient developed one mildly elevated alkaline phosphatase level, but he showed no radiographic evidence of heterotopic ossification and maintained full passive range of motion of the hips.


CONCLUSIONS
This case indicates that hip effusion may be a similar, less-common occurrence than knee effusion in patients with spinal cord injury. In this case, bilateral aseptic hip effusion was not associated with heterotopic ossification. More research is needed to determine the etiology and sequelae of this condition.
Kupfer
Mendel
M
Department of Rehabilitation Medicine, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA. mxkupfer@gmail.com
Dholakia
Madhuri
M
O'Neill
Bryan J
BJ
D000328:Adult; D000469:Alkaline Phosphatase / Q000097:blood; D002574:Cervical Vertebrae / Q000293:injuries; D012090:Cumulative Trauma Disorders / Q000209:etiology*; D006395:Hemarthrosis / Q000209:etiology*; D025981:Hip Injuries / Q000209:etiology*; D006801:Humans; D007592:Joint Diseases / Q000209:etiology*; D008297:Male; D026741:Physical Therapy Modalities / Q000009:adverse effects; D011782:Quadriplegia / Q000534:rehabilitation*; D012307:Risk Factors; D013119:Spinal Cord Injuries / Q000534:rehabilitation*; D016474:Weight-Bearing / Q000502:physiology
D000469:Alkaline Phosphatase