Ahmed M Abdelhai1, Mohammed Hassan Babiker2, Hassan Elbahri3, Dafaalla Salih Altyar4 and Hozifa Mohammed Ali Abd-Elmaged5*
1Assistant Professor, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
2MD Orthopedics and Trauma SMSB, Khartoum, Sudan
3Associate Professor, Faculty of Medicine, International University of Africa, Sudan
4Medical Student at Al-Zaiem Al-Azhari University, Khartoum, Sudan
5Assistant Professor, Faculty of Medicine, University of Khartoum , Kartoum, Sudan
*Corresponding Author: Hozifa Mohammed Ali Abd-Elmaged, Assistant Professor, Faculty of Medicine, University of Khartoum , Kartoum, Sudan.
Received: August 30, 2022; Published: October 11, 2022
Introduction:The misdiagnosis of skeletal manifestation of sickle cell anaemia, Mostly bone Infraction as an infection, depending on the same clinical presentation and the x-ray findings.
Methodology: This is a descriptive prospective multi-centric hospital-based study. conducted in Khartoum, the Capital of Sudan in several hospitals, the study included 50 patients with SCA with skeletal manifestation. Which presented to hospitals during the study period.
Results: Sensitivity, specificity, positive predictive value and negative predictive value of final diagnosis (as osteomyelitis) were 46.7%, 90.9%, 87.5% and 94.7% respectively. The sensitivity, specificity, positive predictive value and negative predictive value of final diagnosis (as bone infarction) were 72%, 53.3%, 94% and 88.9% respectively, which significantly indicates low reliability of using X-Ray in the diagnosis of skeletal manifestations among SCD patients (P < 0.05).
Comparing between initial and final diagnoses realized the tendency to change from infection to infarction after initiation of treatment, which is mostly due to a lack of proper workup.
Radio-leucency was the most common X-Ray finding among the studied patients, followed by osteoscelerosis, joint destruction osteopenia and bone collapse. Finally patients diagnosed with bone infarction, underwent bone debridement in their course of treatment before the definitive diagnosis as infarction and 82% of them were given a long course of antibiotics
Conclusion: We Note the necessity of clinical assessment and x-ray imaging in SCD workup, further imaging and investigation have to be done before diagnosing the patient as osteomyelitis and proceeding with aggressive management. In addition to radioisotope imaging which provides useful information about acute osteomyelitis.
Keywords: Sickle Cell Anaemia (SCA); Red Blood Cell (RBC); Sickling
Citation: Hozifa Mohammed Ali Abd-Elmaged., et al. “Skeletal Manifestations of Sickle Cell Disease, Role of Plain Radiograph in Predicting the Diagnosis and Management". Acta Scientific Orthopaedics 5.11 (2022): 65-70.
Copyright: © 2022 Hozifa Mohammed Ali Abd-Elmaged., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.