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Musculoskeletal Imaging

Hypogammaglobulinaemia

a state of deficiency of plasma gamma globulins and impairment of antibody formation. In the primary form, a diminished rate of synthesis of gamma globulins occurs, whereas the secondary form results from an increased rate of catabolism or loss of gamma globulins in the intestine, urine or skin. Hypogammaglobulinaemia is associated with recurrent and severe infections (sinusitis, otitis media, conjunctivitis, pneumonia, meningitis, septic arthritis and furunculosis) that may involve bones and joints and a rheumatoid arthritis-like chronic asymmetric polyarthritis. In some patients, tuberculosis and fungal disorders also can be apparent.

Musculoskeletal abnormalities include a chronic inflammatory polyarthritis, sometimes with permanent joint damage. In some cases subcutaneous nodules may be seen. On radiographs, soft tissue swelling, periarticular osteoporosis, joint space narrowing and deformities without osseous erosions are observed.

Hypogammaglobulinaemia in patients with plasma cell myeloma results in impairment in humoral immunity and an increased susceptibility to infection. The most frequent sites of infection are the lung and the urinary tract. Some patients may also reveal osteomyelitis and septic arthritis.

DR