Hip paraosteoarthropathy after sciatica nerve injury by quinine intramuscular injection

• Published in: Annales de réadaptation et de médecine physique Vol. 50; no. 1; p. 42
• Main Authors: Kpadonou, G-T, Biaou, O, Fiossi-Kpadonou, E, Hans-Moevi, A-A, Alagnide, E, Odoulami, H
• Format: Journal Article
• Language: French
• Published: Netherlands 01-01-2007
• Subjects: Adult; Antimalarials - administration & dosage; Antimalarials - adverse effects; Female; Hip Joint; Humans; Injections, Intramuscular - adverse effects; Ossification, Heterotopic - etiology; Quinine - administration & dosage; Quinine - adverse effects; Sciatic Nerve - injuries
• ISSN: 0168-6054

Often occurring in central nerve injuries, paraosteoarthropathic conditions are revealed by a stiffness or ankylosis of the joint. Their occurring during peripheral nerve injuries is rare.
To report a case of hip paraosteoarthropathy features after sciatica nerve injury by quinine intramuscular injection.
We report a case of a 24-year-old patient presenting with pain, oedema of the left buttock, limitation of bending of the left hip, and antalgic limping associated with a small step because of axonal left sciatic nerve injury. Initial pelvis X-ray and laboratory findings were normal. Reviewed 4 months later with important stiffness of the left hip, a second X-ray showed an atypical paraosteoarthropathy (POA). Chemotherapy and physiotherapy alleviated neurological muscle weakness but did not have any effect on the hip functionality. Surgical excision was the only treatment that improved the amplitude of movements. Evolution 7 years later showed the disappearance of the peripheral nerve-injury signs and the conservation of the movement amplitude obtained after excision, without a return to normal.
Factors pointing to this POA were initial oedema, immobilization because of pain, and trauma by quinine intramuscular injection. The interest is the exceptional occurrence of POA on a peripheral nerve injury (sciatica nerve injury by quinine injection) outside the context of length resuscitation and that sciatica nerve injury is frequent in tropical countries but anachronistic in a developed one.