HIV/AIDS (musculoskeletal manifestations)

Musculoskeletal manifestations of HIV/AIDS are not as common as CNS or pulmonary complications. Nonetheless, their prevalence is high. 

Depending on the condition, aetiology may be related to the HIV infection itself, the resultant immunodeficiency, or antiretroviral therapy (HAART).

Infection

Infection is common in HIV patients, particularly those with low CD4 counts, and concomitant IV drug users. 

Manifestations include:

  • soft tissue infections: cellulitis, necrotizing fasciitis, abscess formation and pyomyositis
  • osteomyelitis 
    • most common bacterial pathogen is s. aureus
    • tuberculous infection is observed with increasing frequency in this population
    • bacillary angiomatosis is uncommon but specific to the HIV-infected population2,3
  • septic arthritis: likely related to the prevalence of concomitant IV drug use.
  • septic bursitis1
Arthritides
  • HIV: associated arthritis/arthralgia1,4,5 
    • may result from the direct infection of the joint by the HIV virus  
    • usually, this is a self-limiting  mono- or oligoarthropathy, lasting 1-6 weeks
    • tends to affect large joints of the lower limb
    • radiographs are typically normal or demonstrate a joint effusion 
    • less commonly, there is a chronic, erosive arthritis with joint space narrowing
  • Reiter syndrome: may present with an incomplete clinical form of the disease, but radiographic features are the same as in non-HIV infected individuals
  • psoriatic arthritis: higher prevalence than in the non-HIV affected population
  • undifferentiated spondyloarthritis with clinical features of both Reiter’s and psoriatic arthritis
    • possibly the most common form4
    • radiographic findings include osteoporosis, soft-tissue swelling, bone erosions and periosteal reaction
  • rheumatoid arthritis and SLE may improve or remit in the setting of HIV infection
Neoplasms
 Miscellaneous

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Article Information

rID: 12287
Section: Gamuts
Tags: hiv, aids
Synonyms or Alternate Spellings:
  • MSK manifestations of AIDS
  • Musculoskeletal manifestations of HIV

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