Turkish Journal of Physical Medicine and Rehabilitation 2010 , Vol 56 , Num 3

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

Javid Majlesi 1 ,Deniz Mataracı Çevik 1 ,Nurdan Mengi 1 ,Kaya Kanberoğlu 1 ,Meryem Kaya 1 ,Hülya Bingöl 1 ,Levent Alimgil 1 ,Halil Ünalan 2 ,Hüseyin Botanlıoğlu 1
1 Medicana International İstanbul Hastanesi, İstanbul, Türkiye
2 İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, İstanbul, Türkiye
DOI : 10.4274/tftr.141

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. 

Keywords : Wilson disease, involuntary movements, arthropathy, Kayser-Fleischer ringse