title: Hip pain and heart failure: the missing link.
abstract: A man presented with hypothyroidism, dilated cardiomyopathy, a pericardial effusion, liver failure, and polycythaemia. He had a history of bilateral hip replacements and new-onset hip pain. The patient progressed to develop shock. Given his acutely profound illness and constellation of symptoms, as well as the history of hip replacement, a diagnosis of cobalt toxicity was made.
authors: General Internal Medicine, University of Toronto, Toronto, Ontario, Canada. cameron.gilbert@utoronto.ca
authors: Cameron J
authors: CJ
authors: Gilbert
authors: Angela
authors: A
authors: Cheung
authors: Jagdish
authors: J
authors: Butany
authors: Michael G
authors: MG
authors: Zywiel
authors: Khalid
authors: K
authors: Syed
authors: Michael
authors: M
authors: McDonald
authors: Florence
authors: F
authors: Wong
authors: Christopher
authors: C
authors: Overgaard
mesh_terms: D018771:Arthralgia / Q000139:chemically induced*; D019644:Arthroplasty, Replacement, Hip; D002311:Cardiomyopathy, Dilated / Q000139:chemically induced; D003035:Cobalt / Q000009:adverse effects* / Q000097:blood; D004452:Echocardiography; D017809:Fatal Outcome; D006333:Heart Failure / Q000139:chemically induced*; D006621:Hip Joint; D006801:Humans; D007037:Hypothyroidism / Q000139:chemically induced; D008297:Male; D008854:Microscopy, Electron; D008875:Middle Aged; D010003:Osteoarthritis / Q000601:surgery*; D010490:Pericardial Effusion / Q000139:chemically induced; D011086:Polycythemia / Q000139:chemically induced; D011183:Postoperative Complications
chemical_list: D003035:Cobalt