SILICONE BREAST IMPLANT - ASSOCIATED MUSCULOSKELETAL MANIFESTATIONS

Three hundred consecutive women with silicone breast implants (SBI), r eferred to the arthritis clinic with a variety of musculoskeletal comp laints, were evaluated for the presence of underlying connective tissu e disease. A complete history and physical examination were performed, as well as laboratory testing for C-reactive protein, rheumatoid fact or, and autoantibody determination by indirect immunofluorescence and immunodiffusion. The group mean age was 44.4 years (range 25-69), the mean time from initial implant surgery to appearance of symptoms was 6 .8 years (range: 6m-19y) and 83.3% of women studied had clinical manif estations highly suggestive of an underlying connective tissue disorde r. Fifty-four percent met criteria for fibromyalgia and/or chronic fat igue syndrome, distinct connective tissue diseases was detected in 11% , undifferentiated connective tissue disease or human adjuvant disease was found in 10.6%, and a variety of disorders such as angioneurotic oedema, frozen shoulder, multiple sclerosis-like syndrome were present . Several other miscellaneous conditions including recurrent and unexp lained low grade fever, hair loss, skin rash, sicca symptoms, Raynaud' s phenomenon, carpal tunnel syndrome, memory loss, headaches, chest pa in, and shortness of breath were also seen accompanying specific and n on-specific conditions. Seventy percent of patients who underwent expl antation of the implants reported improvement of their systemic sympto matology. A significant proportion of SBI patients referred for rheuma tic evaluation have clinical manifestations highly suggestive of;an un derlying connective tissue disease. Furthermore, improvement of their symptomatology follows explantation of the implants in over half of th e patients.