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Lupus
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Orthopaedic manifestations of the antiphospholipid (Hughes) syndrome

S Vasoo

The Lupus Research Unit, The Rayne Institute, St Thomas’ Hospital, London UK, Rheumatology Section, Department of Medicine, National University Hospital, Singapore

S Sangle

The Lupus Research Unit, The Rayne Institute, St Thomas’ Hospital, London UK

M Zain

The Lupus Research Unit, The Rayne Institute, St Thomas’ Hospital, London UK

D D’Cruz

The Lupus Research Unit, The Rayne Institute, St Thomas’ Hospital, London UK, david.d'cruz{at}kcl.ac.uk

G Hughes

The Lupus Research Unit, The Rayne Institute, St Thomas’ Hospital, London UK

The antiphospholipid (Hughes) syndrome (APS), is characterized by arterial and/or venous thrombosis and pregnancy morbidity in association with antiphospholipid antibodies (aPL). Since its classical description 21 years ago, the clinical spectrum of Hughes syndrome has embraced the realms of obstetrics, nephrology, cardiology, neurology, gastroenterology and now, possibly orthopaedics. This is not surprising, given that this disease can affect virtually any organ system and blood vessel of any size and nature. Just as venous thrombosis may affect limbs and internal organs, arterial thrombosis has been shown to affect organs such as the brain, eye, heart, kidney, liver and may also involve the skeleton. In this review, the skeletal aspects of Hughes syndrome, postulated pathogenesis and possible implications of anticoagulation will be discussed. Finally, the approach to APS patients undergoing orthopaedic surgery shall also be outlined.

Key Words: antiphospholipid syndrome • avascular necrosis • fractures • orthopaedics

Lupus, Vol. 14, No. 5, 339-345 (2005)
DOI: 10.1191/0961203305lu2146rr
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