Bone and Soft-Tissue Disorders
= HANSEN DISEASE
Organism: Mycobacterium leprae
Types:
- lepromatous: in cutis, mucous membranes, viscera
- neural: enlarged indurated nodular nerve trunks; anesthesia, muscular atrophy, neurotrophic changes
- mixed form
- Osseous changes (in 15–54% of patients)
- specific osseous signs of leprosy:
Location: center of distal end of phalanges / eccentric
- ill-defined areas of decalcification, reticulated trabecular pattern, small rounded osteolytic lesions, cortical erosions
- joint spaces preserved
- healing phase: complete resolution / bone defect with sclerotic rim + endosteal thickening
- nasal spine absorption + destruction of maxilla, nasal bone, alveolar ridge
- enlarged nutrient foramina in clawlike hand
- erosive changes of ungual tufts
- nonspecific osseous signs of leprosy:
- soft-tissue swelling; calcification of nerves
- contractures / deep ulcerations
- neurotrophic joints (distal phalanges in hands, MTP in feet, Charcot joints in tarsus)