Skip to main content


Log in

HIV infection and shoulder pain: a challenging case

  • Case Report
  • Published:
Rheumatology International Aims and scope Submit manuscript


With better understanding of the pathogenesis of AIDS and the advent of anti-retroviral medications, patients with HIV are living longer and the probability that they will suffer musculoskeletal complications are increasing. There is a vast array of musculoskeletal impairments including rheumatologic, infectious, and non-infectious conditions. We report a 53-year-old man with longstanding shoulder pain, weakness, and spasticity of the upper extremity which was diagnosed as adhesive capsulitis secondary to brain abscess. Musculoskeletal problems may be complicated with neurological involvement as in our case and patients should be investigated for possible underlying life-threatening disease.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1


  1. Major NM, Tehranzadeh J (1997) Musculoskeletal manifestations of AIDS. Radiol Clin North Am 35(5):1167–1189

    PubMed  CAS  Google Scholar 

  2. Cuellar ML (1998) HIV infection-associated inflammatory musculoskeletal disorders. Rheum Dis Clin North Am 24(2):403–421

    Article  PubMed  CAS  Google Scholar 

  3. Vassipoulos D, Chalasani P, Jurado RL, Workowski K, Agudelo CA (1997) Musculoskeletal infections in patients with human immunodeficiency virus infection. Medicine (Baltimore) 76(4):284–294

    Article  Google Scholar 

  4. Tehrandazeh J, Ter-Oganesyan RR, Steinbach LS (2004) Musculoskeletal disorders associated with HIV infection and AIDS. Part I: infectious musculoskeletal conditions. Skeletal Radiol 33:249–259

    Article  PubMed  Google Scholar 

  5. Buskila D, Tenenbaum J (1989) Septic bursitis in human immunodeficiency virus infection. J Rheumatol 16:1374–1376

    PubMed  CAS  Google Scholar 

  6. Tehrandazeh J, Ter-Oganesyan RR, Steinbach LS (2004) Musculoskeletal disorders associated with HIV infection and AIDS. Part II: non-infectious musculoskeletal conditions. Skeletal Radiol 33:311–320

    Article  PubMed  Google Scholar 

  7. Florence E, Schrooten W, Verdonck K, Dreezen C, Colebunders R (2002) Rheumatological complications associated with the use of indinavir and other protease inhibitors. Ann Rheum Dis 61(1):82–84

    Article  PubMed  CAS  Google Scholar 

  8. Casado E, Olive A, Holgado S, Perez-Andres R, Romeu J, Lorenzo JC, Clotet B, Tena X (2001) Musculoskeletal manifestations in patients positive for human immunodeficiency virus: correlation with CD4 count. J Rheumatol 28:802–804

    PubMed  CAS  Google Scholar 

  9. Brashear A, Zafonte R, Corcoran M, Galvez-Jimenez N, Gracies JM, Gordon MF, McAfee A, Ruffing K, Thompson B, Williams M, Lee CH, Turkel C (2002) Inter- and intrarater reliability of the Ashworth scale and the disability assessment scale in patients with upper-limb poststroke spasticity. Arch Phys Med Rehabil 83(10):1349–1354

    Article  PubMed  Google Scholar 

  10. Hewitt DJ, McDonald M, Portenoy RK, Rosenfeld B, Passik S, Breitbart W (1997) Pain syndromes and etiologies in ambulatory AIDS patients. Pain 70:117–123

    Article  PubMed  CAS  Google Scholar 

  11. Newshan G, Lefkowitz M (2001) Transdermal fentanyl for chronic pain in AIDS: a pilot study. J Pain Symptom Manage 21:69–77

    Article  PubMed  CAS  Google Scholar 

  12. Grasland A, Ziza JM, Raguin G, Pouchot J, Vinceneux P (2000) Adhesive capsulitis of shoulder and treatment with protease inhibitors in patients with human immunodeficiency virus infection report of 8 cases. J Rheumatol 27:2642–2646

    PubMed  CAS  Google Scholar 

  13. Leone J, Beguinot I, Dehlinger V, Jaussaud R, Rouger C, Strady C, Pennaforte JL, Etienne JC (1998) Adhesive capsulitis of the shoulder induced by protease inhibitor therapy, Three new cases. Rev Rhum Engl Ed 65:800–801

    PubMed  CAS  Google Scholar 

  14. Peyriere H, Mauboussin JM, Rouanet I, Rouveroux P, Hillaire-Buys D, Balmes P (1999) Frozen shoulder in HIV patients treated with indinavir: report of three cases. AIDS 13:2305–2306

    Article  PubMed  CAS  Google Scholar 

  15. Zabraniecki L, Doub A, Mularczyk M, Andrieu V, Marc V, Ginesty E, Dromer C, Massip P, Fournie B (1998) Frozen shoulder:a new delayed complication of protease inhibitor therapy? Rev Rhum Engl Ed 65(1):72–74

    PubMed  CAS  Google Scholar 

  16. Subauste CS, Wong SY, Remington JS (1997) AIDS-associated toxoplasmosis. In: Sande MA, Volberding PA (eds) The medical management of AIDS, Chap 24, Saunders, Philadelphia, pp 343–362

  17. Levy RM, Mills CM, Posin JP, Moore SG, Rosenblum ML, Bredesen DE (1990) The efficacy and clinical impact of brain imaging in neurological symptomatic AIDS patients: A prospective CT/MRI study. J Acquir Immune Defic Syndr 3:461–471

    PubMed  CAS  Google Scholar 

  18. Rosensweet E, Fink CJ (1992) Physical therapy for the patient with acquired immunodeficiency syndrome. Clin Podiatr Med Surg 9(4):883–893

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to Ayçe Atalay.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Atalay, A., Özdemir, O., Guven, G.S. et al. HIV infection and shoulder pain: a challenging case. Rheumatol Int 26, 680–682 (2006).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: