We have assessed the nature and significance of musculoskeletal disorders in 166 patients with the commonly encountered forms of hyperlipidaemia attending a lipid clinic. The incidence of musculoskeletal disorders was determined by questionnaire to the patients, inquiries to general practitioners, and a review of hospital records. To ensure the sensitivity of these methods a series of negatively responding cases were seen and examined; none had identifiable musculoskeletal disease. Eight males with type IV hyperlipidaemia had recurrent acute attacks of gout. The only other musculoskeletal disorder possibly attributable to an association with hyperlipidaemia was a transient polyarthritis in 3 patients. This was inflammatory, recurrent, but nondeforming, and involved the small joints of the hand. It did not require any specific therapy or lead to disability. We suggest that, while we have confirmed the association of type IV hyperlipidaemia and gout, there is little evidence for clinically significant arthritis being associated with other commonly presenting forms of hyperlipidaemia, although we accept that the rarely met homozygous familial hypercholesterolaemia may also be complicated by a crystal arthropathy due to the presence of crystalline cholesterol in joints.
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