Bullet-induced synovitis as a cause of secondary osteoarthritis of the hip joint: A case report and review of literature

BACKGROUND: With increasing prevalence of gunshot injuries we are seeing more patients with retained bullet fragments lodged in their bodies. Embedded lead bullets are usually considered inert after their kinetic energy has dissipated hence these are not removed routinely. However, exposure of any foreign body to synovial fluid may lead to rapid degradation and hence result in systemic absorption, causing local and systemic symptoms. We present the case of a thirty year old man who came to our out patient department with a history of progressive, severe hip pain ten years after a gun shot injury to his right hip. CONCLUSION: The common belief that intraarticular bullets should not be removed has no benefit and may result in unwanted long term complications.