Skeletal Radiology

, Volume 24, Issue 5, pp 357–360 | Cite as

Lead arthropathy: a cause of delayed onset lead poisoning

  • Wilfred C. G. Peh
  • William R. Reinus
Articles

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.

Key words

Arthropathy, lead Intoxication, lead Trauma, gun shot wound 
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Copyright information

© International Skeletal Society 1995

Authors and Affiliations

  • Wilfred C. G. Peh
    • 1
  • William R. Reinus
    • 2
  1. 1.Department of Diagnostic RadiologyUniversity of Hong Kong, Queen Mary HospitalHong Kong
  2. 2.Mallinckrodt Institute of Radiology, Washington, University School of MedicineSt. LouisUSA

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