The prevalence and factors associated with musculoskeletal disorders in patients with Sickle Cell Anamia at Mulago National Referral Hospital

Abstract

Introduction: Musculoskeletal System (MSK) disorders are common manifestation of sickle cell anaemia (SCA). These disorders may include avascular necrosis (AVN), osteomyelitis, leg ulcers or septic arthritis. Early diagnosis and appropriate treatment is important for desirable outcomes. Objectives: This study determined the prevalence of, patterns and factors associated with musculoskeletal disorders, among sickle cell anaemia patients seen at Mulago National referral hospital. Methods: This was a descriptive cross-sectional study, conducted at the Sickle Cell Clinic at Mulago National referral hospital. Three hundred and sixty five sickle cell anaemia patients were recruited. This was done over a period of 2 months between 1st August 2014 and 31st October 2014. The patients were recruited by systematic sampling and examined for the presence of musculoskeletal disorders after obtaining the required history. Relevant radiological, haematological, clinical chemistry and microbiological studies were done as indicated.

Results: The mean age of the patients was 9.4 years. The prevalence of MSK disorders among sickle cell anaemia patients was found to be 11.5%. These disorders include avascular necrosis, spine osteonecrosis, osteomyelitis, leg ulcers, pathological fractures and flexion contractures. The age (11-20 years), highly demanding physical activity status and the annual frequency of painful crises were significantly associated with musculoskeletal disorders among sickle cell anaemia patients. Conclusion: Musculoskeletal disorders are among the major causes of morbidity in SCA patients at Mulago National Referral Hospital. Avascular necrosis of the femoral head, spine osteonecrosis, leg ulcers and osteomyelitis were the most common musculoskeletal disorders affecting sickle cell patients. The understanding of factors associated with these disorders, should be applied where possible for prevention, early diagnosis and treatment.