Learning objectives
Understand the range of pathologies that can effect the musculoskeletal system in HIV
Review the multimodality imaging features of a range of these pathologies in our institution.
Inform the radiologist of the things to be aware of when working in an area with high HIV prevalence
Background
The musculoskeletal system can be affected by a number of conditions in HIV and the prevalence of these complaints is high with a reported incidence between 5.5% and 11%.
Compared to CNS,
respiratory and gastrointestinal manifestations of HIV,
musculoskeletal disorders have been less well documented and are arguably less well understood.
The underlying mechanisms leading to these complications are complex and thought to be multifactorial,
involving not only the immunosuppressed status of the patient,
but also the virus itself,
as well as complex immunologic,
environmental,...
Imaging findings OR Procedure details
349 HIV positive patients were seen in a specialist joint HIV/rheumatology clinic between 4/2/2002 and 1/12/2011. Of this group of patients a number of specific diagnoses were made with the help of imaging.
Multi-modality imaging of HIV associated myopathy,
arthropathy,
spondyloarthrophy,
musculoskeletal infection and neoplasm from our institution are demonstrated.
Arthropathies
Arthalgia and arthritis was the most common complaint in HIV positive patients our joint HIV/Rheumatology clinic. The classification can be difficult as patients often present with non-specific symptoms and incomplete manifestations of specific arthritides....
Conclusion
Imaging is key in the investigation of HIV associated musculoskeletal conditions. It can increase the specificity of diagnosis in an area where a myriad of overlapping clinical syndromes can make treatment decisions difficult.
In the acute setting it can aid in the diagnosis and management of opportunistic infections. It is important that radiologists are aware of the spectrum of musculoskeletal abnormalities that can be seen in HIV and how imaging can aid the clinician
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