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E1773. Musculoskeletal Disease in Patients With Human Immunodeficiency Virus (HIV): Memory AIDS
Authors
  1. Siddharth Pandya; Creighton University Arizona Health Alliance
  2. Nicholas Meermeier; Creighton University Arizona Health Alliance
  3. Bryant Brown; Creighton University Arizona Health Alliance
  4. Paulo Miro; University of Arizona - College of Medicine - Phoenix
  5. Dan Gridley; Creighton University Arizona Health Alliance
Background
Patients with human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) are prone to unique musculoskeletal pathologies. While the musculoskeletal pathologies are less common than central nervous system (CNS) disorders and pulmonary disease unique to HIV-infected and AIDS patients, there are a wide range of soft tissue, articular, and osseous manifestations that may arise. The etiologies of the musculoskeletal manifestations are complex and multifactorial. The pathophysiologies are largely driven by the immunosuppression secondary to an impaired T-lymphocyte response; however, there are also complex immunologic and environmental factors that result in infectious, inflammatory, and neoplastic processes that either show a higher incidence or are unique to this population of patients. Some pathologies described in this presentation are seen in the general population or in other forms of immunosuppression, while others are specific to HIV-infected and AIDS patients.

Educational Goals / Teaching Points
This exhibit provides a pictorial review of some musculoskeletal pathology associated with HIV and AIDS patients. After viewing this presentation, when presented with an imaging study in HIV-positive and AIDS patients, the reader should be able to expand their differential diagnoses to include musculoskeletal manifestations unique to this disease. The reader should also be able to understand the use of different imaging modalities in the evaluations of these various pathologies.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
A review of the soft tissue, articular, and osseous manifestations associated with HIV-infected and AIDS patients will be discussed. Cases featuring infectious soft tissue pathologies including osteomyelitis, pyomyositis, and necrotizing fasciitis will be reviewed, and the distinguishing imaging features will be highlighted. The articular processes including reactive arthritis and psoriatic arthritis will be compared with a review of their key distinguishing imaging features. The imaging features of Kaposi Sarcoma and Non-Hodgkin lymphoma, two of the most common neoplasms seen in AIDS patients, will be reviewed. For each case, the imaging findings will be compared on multiple modalities including radiography, CT, and MRI.

Conclusion
Imaging plays a crucial role in the evaluation of HIV-positive and AIDS patients. An understanding of the musculoskeletal manifestations of this disease will allow the radiologist to provide more accurate interpretations that effectively guide patient management.