Implant-related inflammatory arthritis.
BACKGROUND
A 54-year-old woman presented with myalgia and arthralgia predominantly in the knees and small joints of the hands and feet with morning stiffness lasting for at least 2 h. The patient had received a wrought titanium 6-aluminium 4-vanadium alloy C cage implant 1.5 years previously, following a severe disc prolapse. No signs of rheumatic disease were evident before the C cage was implanted.


METHODS
Physical examination, radiography, skin and muscle biopsies, serology tests, white blood cell count, HLA genotyping, tumor necrosis factor release assay, skin patch test, lymphocyte transformation test.


METHODS
Implant-related inflammatory arthritis.


RESULTS
Combination therapy with corticosteroids, disease-modifying antirheumatic drugs and nonsteroidal anti-inflammatory drugs, and replacement of the titanium cage with a polyetherketone cage.
Dörner
Thomas
T
Coagulation Unit, Institute of Transfusion Medicine, Charité University Medicine, Berlin, Germany. thomas.doerner@charite.de
Haas
Judith
J
Loddenkemper
Christoph
C
von Baehr
Volker
V
Salama
Abdulgabar
A
D018771:Arthralgia / Q000209:etiology*; D001168:Arthritis / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D017586:Diskectomy / Q000009:adverse effects; D005260:Female; D006684:HLA-DR Antigens / Q000276:immunology; D059811:HLA-DRB1 Chains; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D019736:Prostheses and Implants / Q000009:adverse effects*; D014025:Titanium; D017211:Treatment Failure
D006684:HLA-DR Antigens; D059811:HLA-DRB1 Chains; D014025:Titanium