Progression of acral bone resorption in multibacillary leprosy.

Although leprosy became a curable disease after implementation of the Global Strategy for the Elimination of Leprosy (WHO), mutilations and deformities are still commonplace in endemic countries. Hence, it remains important to evaluate the prevalence rate and the risk factors of acral bone resorption in the multidrug therapy (MDT) era. A cohort of 105 newly-diagnosed adult multibacillary leprosy patients admitted for treatment between 1990-1992 was surveyed until 1999. Progression of bone resorption (BR) in cured leprosy patients was observed up to 8 years after release from MDT. Twenty three percent of the patients were found to have acral resorption. BR was found to be associated with male sex, grade of disability at diagnosis with other deformities and with the occurrence of four or more lepra reactions. Patient surveillance after release from MDT continues to be a necessary procedure in individuals with disabilities and recurrent or persistent reactions.

Bone loss in limbs with decreased or absent sensation: ten year follow-up of the hands in leprosy.

Three hundred and sixty-seven patients with insensitive hands have been studied by correlating radiologic findings with occupational and medical history in order to better define causal factors in bone resorption. This study indicates that nonspecific infection and trauma are the reasons for bone resorption in 98% of cases. The role of intermittent pressure seems to be in soft tissue breakdown, which then allows bone to become infected. Bone resorption can be arrested at any stage of the disease by appropriate therapy of splinting and control of infection.

Bone changes in leprosy. A study of 50 cases.

The radiological bone changes have been studied in 50 patients comprising of lepromatous, tuberculoid, mixed (borderline lepromatous, borderline tuberculoid, dimorphous) and polyneuritic (neural) types of leprosy of which the former formed the largest group. The overall incidence of non-specific bone changes is higher as compared to specific bone changes. These were found to have highest incidence in the lepromatous type of leprosy, in the occupational group of manual workers and from 3rd to 6th decade of life. With the longer duration of the disease, the incidence of non-specific bone changes is also more.

Radiological changes in serial x-rays of the foot and tarsus in leprosy.

Most bone abnormalieis seen in serial films of the feet in leprosy were static being the end result of old disease. Changes over a period of time were observed in serial fims of 214 feet and these changes were due to a combination of infection, neuropathic changes and avascular necrosis occurring in anaesthetic feet. The bone abnormalities seen were absorption of toes and metatarsals; bone destruction; a neuropathic arthropathy of toes and metatarsals and various patterns of tarsal disintegration.