A 'made in one piece' skeleton in a 22-year-old man suffering from sickle cell anaemia

A 22-year-old African male with known sickle cell anaemia was referred by a Congolese medical centre with a request to improve his poor physical condi tion. He was unable to walk, stand or sit because his large joints and his spine were either ankylosed or very rigid. Radiographs showed joint fusion from the third to the fifth cervical vertebrae, of both hips, of the left k nee, and a bilateral osteonecrosis of the humeral head. There was no scinti graphic evidence for an active osteomyelitis (Tc-99m-MDP (methyldiphosphona te) bone scan, Tc-99m monoclonal antigranulocyte scan and Tc-99m sulphur co lloid scan). To improve his mobility the right femoral head was resected in June 1997; 14 days later the left femoral head was resected. Four months a fter the resection of the right hip, a right uncemented total hip prosthesi s was implanted on this side. One month later the same type of hip arthropl asty was performed on the left side. During the postoperative rehabilitatio n period the patient regained autonomy. We have found no previous reports o f such severe and multiple joint complications in a single patient sufferin g from sickle cell anaemia.