COVID-19 has variable clinical presentations, severity, and multisystem involvement. Some patients have encountered arthralgia and myalgia symptoms. Reactive arthritis is an emerging musculoskeletal manifestation post-COVID-19 infection. The authors report a 29-year-old male, previously healthy, who developed acute left hip arthritis 8 weeks after recovering from severe COVID-19 pneumonia. It was associated with bilateral avascular necrosis of femoral heads, with medullary bone infarctions at both proximal tibias. Human leukocyte antigen-B27 was positive and synovial fluid culture, autoimmune workup, crystals, and infectious aetiologies were negative. The patient’s clinical condition improved with the use of non-steroidal anti-inflammatory drugs and physiotherapy. To the best of the authors’ knowledge, this is the first case reported of hip arthritis and avascular necrosis following the COVID-19 infection. In addition, the authors reviewed the literature for the reported reactive arthritis cases post-COVID-19 infection and management outcomes.
Rosuvastatin-received group and placebo-received group respectively and there was a significant difference between groups (p-value:0.04). Conclusions: Based upon our data and similar previous studies, It's believed that Rosuvastatin could be considered as a protective agent against CI-AKI and can reduce renal injuries and decreased eGFR related to contrast injection.
Introduction: Brucellosis is a zoonotic infection caused by the aerobic Gram-negative bacteria coccobacilli, and is considered a public health problem in the Mediterranean region and Arabian Peninsula. This paper studied the clinical characteristics of musculoskeletal brucellosis and the outcomes of treatment in Al Ain City, United Arab Emirates.
Method: A retrospective chart review study was conducted at Tawam Hospital over seven years: January 2009–January 2016. Risk factors for brucellosis, musculoskeletal (MSK) manifestations, duration of Brucella infection (acute, subacute, chronic), and treatment were studied.
Results: A total of 99 patients were diagnosed with brucellosis during the study period; the mean age was 44 years, the majority were males (71%), and the male to female ratio was 3:1. The most common risk factor for Brucella infection in the cohort was drinking raw milk (43.4%). Fever was the most common presenting symptoms (93%), followed by arthralgia, fatigue, and loss of appetite in 35, 21, and 14%, respectively. The clinical manifestations of brucellosis in the cohort were MSK involvement (30%), hepatitis (17%), epididymo-orchitis (2%), and endocarditis (1%). Thirty percent of patients (n=30) had MSK-specific symptoms and only one-third (n=10) had confirmatory positive radiographic findings. The majority of patients had lumbar and sacroiliac joint involvement. Most of the patients received antibiotics for a 4–8-week duration and the overall relapse rate of Brucella infection was 10%.
Conclusion: This study demonstrates that MSK involvement is a common manifestation in brucellosis, occurring in one-third of the cases. The index of suspicion should be high in brucellosis-endemic countries for early recognition and treatment.
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