Symptomatic Joint Effusions in Sickle Cell-β-Thalassemia Disease

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Abstract
ARTHRALGIAS and joint effusions have been observed in patients with sickle cell disease (hemoglobin SS).1,2In addition, joints may be involved in sickle cell disease by gout and septic arthritis. Aseptic necrosis occurs with sickle cell disease,3,4hemoglobin SC disease,3and hemoglobin SA disease.5 In sickle cell-β-thalassemia, aseptic necrosis3,6has been noted, but other types of arthropathy have not been demonstrated. In one report1on arthropathy of sickle cell disease, casual observation of patients with sickle cell-thalassemia and joint effusions unrelated to crisis was mentioned in passing. This report describes clinical and synovial fluid findings in a patient with sickle cell-β-thalassemia and symptomatic joint effusions. Report of a Case A 27-year-old black man was seen at the Mayo Clinic complaining of recurrent myalgias and polyarthralgias, with intermittent swelling of the knees and elbows since he was 5 years of age. The patient had had