Skip to main content
PMC home page
Annals of the Rheumatic Diseases logoLink to Annals of the Rheumatic Diseases
. 1977 Apr;36(2):99–111. doi: 10.1136/ard.36.2.99

Arthropathy of Wilson's disease. Study of clinical and radiological features in 32 patients.

D N Golding, J M Walshe
PMCID: PMC1006644  PMID: 857745

Abstract

The principal clinical features and radiological findings relating to the locomotor system have been studied in 32 consecutive hospital admissions of patients with Wilson's disease. 5 of these patients were recently diagnosed and had as yet received no treatment, while 27 were routine admissions for follow-up and biochemical supervision of their illness. No patient was specifically included or excluded from the series because of the presence or absence of locomotor symptoms. The most common radiological abnormality was a generalized increase of radiolucency, interpreted as skeletal demineralization (21 cases), followed by premature osteoarthrosis (8 cases). Changes in the spine were common and included osteochondritis, reduction of intervertebral joint spaces, osteoarthrosis, and a tendency to squaring of vertebral bodies. Other bony changes included fluffy irregularity of femoral trochanters, osteochondritis dissecans of the knees, osteophytic protrusions at bone ends, and bunches of tongue-like osteophytes at joint margins. The symptoms associated with these radiological abnormalities comprised back pain and stiffness with restricted movement, pain and stiffness of knees, hips, and wrists, and tenderness to pressure over margins of affected joints. Joint hypermobility was also observed in 9 patients. Episodes of acute polyarthritis with serological changes were seen in 5 cases; all these episodes appeared to be related directly to treatment with penicillamine.

Full text

PDF
103

Images in this article

105Image
on p.105
105Image
on p.105
106Image
on p.106
106Image
on p.106
107Image
on p.107
108Image
on p.108
108Image
on p.108
109Image
on p.109
109Image
on p.109
110Image
on p.110

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Asatoor A. M., Miline M. D., Walshe J. M. Urinary excretion of peptides and of hydroxyproline in Wilson's disease. Clin Sci Mol Med. 1976 Oct;51(4):369–378. doi: 10.1042/cs0510369. [DOI] [PubMed] [Google Scholar]
  2. BEARN A. G., YU T. F., GUTMAN A. B. Renal function in Wilson's disease. J Clin Invest. 1957 Jul;36(7):1107–1114. doi: 10.1172/JCI103506. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Boudin G., Pépin B., Godeau P., Vernant J. C., Gouerou H. Lupus érythémateux induit par la pénicillamine au cours d'une maladie de Wilson. Ann Med Interne (Paris) 1971 Feb;122(2):269–273. [PubMed] [Google Scholar]
  4. Cavallino R., Grossman H. Wilson's disease presenting with rickets. Radiology. 1968 Mar;90(3):493–494. doi: 10.1148/90.3.493. [DOI] [PubMed] [Google Scholar]
  5. DENT C. E., STOWES J. M. ADULT FANCONI SYNDROME AND CIRRHOSIS. Br Med J. 1965 Feb 20;1(5433):520–520. doi: 10.1136/bmj.1.5433.520. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. FINBY N., BEARN A. G. Roentgenographic abnormalities of the skeletal system in Wilson's disease (hepatolenticular degeneration). Am J Roentgenol Radium Ther Nucl Med. 1958 Apr;79(4):603–611. [PubMed] [Google Scholar]
  7. Feller E. R., Schumacher H. R. Osteoarticular changes in Wilson's disease. Arthritis Rheum. 1972 May-Jun;15(3):259–266. doi: 10.1002/art.1780150307. [DOI] [PubMed] [Google Scholar]
  8. Hamilton E., Williams R., Barlow K. A., Smith P. M. The arthropathy of idiopathic haemochromatosis. Q J Med. 1968 Jan;37(145):171–182. [PubMed] [Google Scholar]
  9. Harpey J. P., Caille B., Moulias R., Goust J. M. Lupus-like syndrome induced by D-penicillamine in Wilson's disease. Lancet. 1971 Feb 6;1(7693):292–292. doi: 10.1016/s0140-6736(71)91022-1. [DOI] [PubMed] [Google Scholar]
  10. Kaklamanis P., Spengos M. Osteoarticular changes and synovial biopsy findings in Wilson's disease. Ann Rheum Dis. 1973 Sep;32(5):422–427. doi: 10.1136/ard.32.5.422. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. MORGAN H. G., STEWART W. K., LOWE K. G., STOWERS J. M., JOHNSTONE J. H. Wilson's disease and the Fanconi syndrome. Q J Med. 1962 Jul;31:361–384. [PubMed] [Google Scholar]
  12. Mehta R. S., Shinde V. A. Wilson's disease with rickets. Neurol India. 1965 Apr-Jun;13(2):67–73. [PubMed] [Google Scholar]
  13. Mindelzun R., Elkin M., Scheinberg I. H., Sternlieb I. Skeletal changes in Wilson's disease. A radiological study. Radiology. 1970 Jan;94(1):127–132. doi: 10.1148/10.1148/94.1.127. [DOI] [PubMed] [Google Scholar]
  14. Morris J. J., Seifter E., Rettura G., Geever E. F., Levenson S. M. Effect of penicillamine upon healing wounds. J Surg Res. 1969 Mar;9(3):142–149. doi: 10.1016/0022-4804(69)90045-6. [DOI] [PubMed] [Google Scholar]
  15. Oliver I., Liberman U. A., DeVries A. Lupus-like syndrome induced by penicillamine in cystinuria. JAMA. 1972 Apr 24;220(4):588–588. doi: 10.1001/jama.1972.03200040100036. [DOI] [PubMed] [Google Scholar]
  16. ROSENOER V. M., MICHELL R. C. Skeletal changes in Wilson's disease (hepato-lenticular degeneration). Br J Radiol. 1959 Dec;32:805–809. doi: 10.1259/0007-1285-32-384-805. [DOI] [PubMed] [Google Scholar]
  17. Rasmussen K. Observations during treatment of cystinuria with D-penicillamine. Acta Med Scand. 1971 May;189(5):367–372. doi: 10.1111/j.0954-6820.1971.tb04391.x. [DOI] [PubMed] [Google Scholar]
  18. WALSHE J. M. Wilson's disease. The presenting symptoms. Arch Dis Child. 1962 Jun;37:253–256. doi: 10.1136/adc.37.193.253. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. WARNOCK C. G. Hepatolenticular degeneration; Wilson's disease; a report of five cases, with commentary. Ulster Med J. 1952 Nov 1;21(2):155–171. [PMC free article] [PubMed] [Google Scholar]

Articles from Annals of the Rheumatic Diseases are provided here courtesy of BMJ Publishing Group

RESOURCES