Article Text

AB1086 Pathological fracture revealing severe tabetic arthropathy
  1. K. Berrada1,
  2. H. Hachimi1,
  3. L. Tahiri1,
  4. L. Benchat2,
  5. F.Z. Mernissi2,
  6. T. Harzy1
  1. 1Rheumatology
  2. 2Dermatology, Hassan 2 University Hospital, Fez, Morocco


Background Tabetic arthropathy is a devastating complication of neuro-syphilis, now becoming scarce due to early treatment of syphilis.The articular involvement may concern every joint, but more particularly concerns those of the lower limbs.

Methods We report a new case of tabetic arthropathy revealed by pathological fracture.

Results A 43-year-old man with a history of genital ulcer 20 years earlier presented with progressive painless swelling of the right knee lasting for four years. Two months before his admission, he suffered from a functional disability following a small trauma.The clinical examination revealed an important painless non-inflammatory hydarthrosis of the right knee, genu varum deformity, ligamentous laxity, and bilateral patellar hyporeflexia. Knee radiographs showed a hypertrophic arthropathy with fracture-dislocation of the distal femur, a massive joint destruction, fragmentation, bone sclerosis, and enormous osteophytosis formation. The syphilitic serology was positive in blood, cerebrospinal fluid (CSF) and synovial fluid. A treatment by G-penicillin was introduced. Surgical treatment was not possible because of the important osteoarticular destructions.

Conclusions Our case illustrates the difficulty in therapeutic management of tabetic arthropathy which is a severe disease responsible of functional disability affecting quality of life. The best treatment is prevention based on the detection and treatment of syphilis at an early stage before the occurrence of joint and neurological complications.

Disclosure of Interest None Declared

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