Osteoarticular changes and synovial biopsy findings in Wilson's disease.

Wilson's disease (hepatolenticular degeneration) is an uncommon recessively inherited disease, in which various osteoarticular changes have been described (Finby and Beam, 1958; Rosenoer and Michell, 1959; Walshe, 1962; Boudin, Pepin, and Hubault, 1964; Charbonnel, Vercelletto, LeMouroux, Besan9on, and Feve, 1965; Mehta and Shinde, 1965; Cavallino and Grossman, 1968; Mindelzun, Elkin, Scheinberg, and Sternlieb, 1970; Feller and Schumacher, 1972). Some patients with Wilson's disease present with arthralgia of the knees (Walshe, 1962) or have clinical signs or symptoms of osteoarthropathy (Feller and Schumacher, 1972). The mechanism of most osteoarticular changes in Wilson's disease is unclear: copper overloading, renal tubular dysfunction, chronic spasticity and tremor, and liver failure have all been held responsible (Finby and Bearn, 1958; Feller and Schumacher, 1972). Studies of synovial histology of only two patients with Wilson's disease have been published (Mindelzun and others, 1970; Feller and Schumacher, 1972). The synovial lesions present in haemochromatosis have, however, been described (Walker, Dymock, Ansell, Hamilton, and Williams, 1972), where mechanisms similar to those of Wilson's disease have been proposed (McCarty, Pepe, Solomon, and Cobb, 1970) Our interest in the osteoarticular changes and synovial membrane lesions in Wilson's disease goes back to 1968 when we examined a patient with osteoarticular changes in most of the joints. Since then we have studied six more patients.