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Bone and Joint Lesions in Leprosy

1948; Radiological Society of North America; Volume: 50; Issue: 5 Linguagem: Inglês

10.1148/50.5.619

1527-1315

Gonzalo Esguerra-Gómez, Emilio Acosta,

Oral Health Pathology and Treatment

In the few patients with leprosy presenting themselves at the x-ray laboratories in Bogotá, the majority without a clinical diagnosis of the disease, an opportunity was afforded to observe in the bones of the hands and feet trophic lesions sufficiently characteristic to make possible a radiologic diagnosis. In view of these observations, it was decided to undertake a more complete study of the bone changes in leprosy. This was the more easily accomplished since in Colombia lepers are isolated in leprosariums, a practice due rather to the traditional fear of the disease than to any actual danger of contagion. My distinguished pupil and collaborator, Dr. Emilio Acosta, served for two years as head of the X-ray Department at the lazaretto in Agua de Dios, where he not only attended those patients requiring x-ray service but also obtained films of the hands and feet which have contributed greatly to our investigation. Between 1932 and 1940 there were published three radiological reports covering 231 cases of leprosy (Murdock and Hutter; Karaseff; Oberdoerffer and Collier). Karaseff and Murdock and Hutter were of the opinion that the bone lesions of leprous origin are located exclusively in the hands and feet. Dr. Acosta, after studying over 1,000 lepers confirmed this view, adding: “Of the organs examined, only the larynx showed some suspicious changes. There occur a variety of lesions of other types in all the bones and joints, as osteoarthritis (tuberculous) of the hip, wrist, and knee; hypertrophic arthritis of the spine; fractures of all varieties; tumors, and finally periostitis and hyperostoses of the bones of the legs as a result of chronic irritation in patients with trophic cutaneous ulcers, which, by the way, were frequent. We also found pulmonary tuberculosis, gastric carcinoma, and other diseases in association with leprosy.” It was decided, in view of Dr. Acosta's conclusions, confirming those previously published, to limit our study to the bones of the hands and feet. Films were obtained of 532 persons—483 with leprosy, 5 suspected of having the disease, and 44 in normal health. Films of the hands numbered 469, of the feet 372. Among the 483 lepers examined, all variations of the disease were found. Because of this, it may be well to explain the two classifications kept in view throughout our study, one scientific and the other administrative.