Less Common Arthropathies

C. Hyperlipoproteinemia and Arthritis
  • Robert F. Spiera


  • Several recognized heritable disorders of lipid metabolism result in a variety of clinical phenotypes, each of which may be associated with distinct musculoskeletal manifestations.

  • Tendinous xanthomas are associated most often with the type II and type III hyperlipoproteinemias, known respectively as familial hypercholesterolemia and familial dysbetalipoproteinemia.

  • Tendinous xanthomas characteristically occur on the dorsum of the hands over the digit extensor tendons, or on the heels at the Achilles tendon insertions.

  • Osseous xanthomas, observed occasionally in type III hyperlipoproteinemia, can predispose patients to pathologic fractures, particularly in long bones.

  • An episodic, acute, migratory inflammatory arthritis occurs in up to 50% of homozygotes with type II hyperlipoproteinemia. The joints are erythematous, warm, and swollen, and acute-phase reactants are elevated.

  • ■ Gout can be associated with hypertriglyceridemia in types I, IV, and V hyperlipoproteinemia.


Primary Biliary Cirrhosis Familial Hypercholesterolemia Heritable Disorder Gouty Tophus Retrocalcaneal Bursa 
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© Springer Science+Business Media, LLC. 2008

Authors and Affiliations

  • Robert F. Spiera
    • 1
  1. 1.Department of Medicine/RheumatologyMount Sinai School of MedicineUSA

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