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Musculoskeletal complications in sickle cell anemia patients: a ten-year retrospective review of hospital-based records (1991-2000) in two Nigerian hospitals

Salamatu Umar Aliyu, Adamu A. Rufa’I, Ismaila A. Saidu, Abdurrahman M. Jajere.

Background: Sickle Cell Anaemia (SCA) presents with various types of clinical manifestations that includes musculoskeletal manifestations that need the intervention of medical personnel including physiotherapy. The study aimed to determine the various musculoskeletal disorders associated with Sickle Cell Anaemia (SCA), types of treatments given including physiotherapy and the mortality rate in SCA patients admitted in two Nigerian hospitals.
Methods: It is a retrospective quantitative review of hospital-based records using patient’s files and hospital registers. Ten years case notes of SCA patients were reviewed in two hospitals in Kano, North Western Nigeria. Information on age, gender, types of musculoskeletal disorders, types of treatments received including referrals for physiotherapy and number of deaths recorded within this period.
Results: Records shows a total of 248 patients admitted with SCA over this period. Results revealed 133 (53.6%) males and 115 (46.4%) females. Prevalence of musculoskeletal disorders was found to be 172 (54.1%) out of the 318 SCA cases admitted. The commonest cause of hospital visitation was painful bone crisis (35.5%). Followed by osteomyelitis and dactylitis accounting for 20 (11.6%) of the musculoskeletal disorders respectively. Overwhelming majority 61.7% presenting with musculoskeletal disorders are between the age of 3 months and 10 years. The mortality rate was about 22/248 (8.9%). Only 8.9% of these cases received physiotherapy.
Conclusions: Sickle cell disease affect a wider group of people than is commonly realised, screening for the disease is not universal and this together with a general lack of multi-disciplinary qualitative and clinical evidence-based treatment, leads to many inadequate management of individuals. Physiotherapy is one of the health care services that can be given following musculoskeletal presentations, yet it appropriateness in relation to the disease is rarely being addressed.

Key words: Sickle cell anaemia, Musculoskeletal complications, Physiotherapy

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