Differential diagnosis of bone pain in sickle cell disease HY
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Bone pain in sickle cell disease can be caused by vaso-occlusive crisis, osteomyelitis, or avascular necrosis. Vaso-occlusive crisis presents with acute, severe pain in multiple sites that may be preceded by a trigger like dehydration. Osteomyelitis causes acute or subacute pain at a single site along with prolonged fever, erythema, and warmth. A positive blood culture also indicates osteomyelitis. Avascular necrosis results in chronic, worsening pain at a site like the femoral head without fever, warmth, or erythema.
Differential diagnosis of bone pain in sickle cell disease HY
- 1. Differential diagnosis of bone pain in sickle cell disease Cause Vaso-occlusive crisis Osteomyelitis Avascular necrosis Clinical features Acute, severe pain Pain >1 site (eg, dactylitis) +/- Low-grade fever Erythema & warmth May be preceded by trigger (eg, dehydration) Acute or subacute pain Focal pain at 1 site (eg, long bone) Prolonged fever Erythema & warmth Positive blood culture Chronic, worsening pain (eg, femoral head) Absence of fever Absence of warmth or erythema