Less common arthropathies C. hyperlipoproteinemia and arthritis

Abstract

Several recognized heritable disorders of lipid metabolism result in a variety of clinical phenotypes, each of which may be associated with distinct musculoskeletal manifestations. Tendinous xanthomas are associated most often with the type II and type III hyperlipoproteinemias, known respectively as familial hypercholesterolemia and familial dysbetalipoproteinemia. Tendinous xanthomas characteristically occur on the dorsum of the hands over the digit extensor tendons, or on the heels at the Achilles tendon insertions. Osseous xanthomas, observed occasionally in type III hyperlipoproteinemia, can predispose patients to pathologic fractures, particularly in long bones. An episodic, acute, migratory inflammatory arthritis occurs in up to 50% of homozygotes with type II hyperlipoproteinemia. The joints are erythematous, warm, and swollen, and acute-phase reactants are elevated. Gout can be associated with hypertriglyceridemia in types I, IV, and V hyperlipoproteinemia. © 2008 Springer Science+Business Media, LLC. © 2008 Springer-Verlag New York.