Shaerf and Mann reported a triad that can help to identify a patient with a neurotoxic complication of an orthopedic joint prosthesis. The manifestations may be vague and nonspecific, resulting in a delay in diagnosis.
Triad of findings:
(1) presence of an unexplained neurologic finding (nerve deafness, visual disturbance, paresthesias, neuropathy, etc)
(2) presence of a metal-on-metal joint prosthesis (usually of the hip)
(3) elevated serum levels of cobalt and/or chromium
A patient with the triad should be evaluated by a specialist familiar with complications of joint prostheses. The patient may benefit from replacement of the prosthesis.
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