Wilson's Disease Presented with Severe Low Back and Hip Pain as Initial Symptoms and Subsequent Involuntary Movements: A Case Report

Abstract

A forty-six-year-old male patient was admitted to the hospital with complaints of severe low back and hip pain as well as involuntary body and limb movements. Physical examination revealed left-sided hemiballismus, limited and painful movements of the low back, hip and sacroiliac joints, and Kayser-Fleischer ring on eye examination. Magnetic resonance imaging (MRI) findings of the cranium and lumbar spine were normal. MRI of the hip and sacroiliac joints demonstrated sacroiliac joint effusion, bone marrow edema in both femoral heads, and bilateral psoas bursitis. Hypometabolism was found in the right basal ganglia on Flourodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT). Hepatic and neurologic symptoms are the first manifestation of Wilson's disease in 30-40% of patients. Wilson disease is one of well known cause of arthropathy, however this is very rare condition. Wilson's disease should be kept in mind in patients with arthropathy and also hepatic or neurologic symptoms. Turk J Phys Med Rehab 2010;56:141-4.