Cancer induced rheumatism, neurogenic artropathy (charcot joint), palindrome rheumatism, and osteonecrosis can damage joints of the hips, knees, and other joints:

• Rheumatic Manifestation of Cancers: a number of cancers can have rheumatic manifestation:
• Dermatomyositis is often associated with cancers
•  Malignant (lung and intrathoracic cancers) and non-malignant cancers – cyanotic heart Disease, cirrhosis, and lung asbscesses – can cause hypertrophic pulmonary osteoarthropathy with definitive features:
• Triad of polyarthritis
• New onset of finger clubbing and
• Periosteal new Bone formation
• Polyarthritis related to cancers is rare:
• It has both oligoarticular and polyarticular forms and
• Should be suspected if “seronegative rheumatoid arthritis” develops in the elderly
• Bilateral palmar swelling with finger contractures – palmar fasciitis – may be the first sign of cancer such as ovarian carcinoma 
• Small joint polyarthritis associated with non-pitting edema of the hands is manifestation of remitting seronegative synovitis with non-pitting edema. The cancer can be idiopathic or can be caused by malignant cancer
• In myeloproliferative disorders, palpable purpura due to leukocytoclastic vasculitis maybe the only sign
• Hairy-cell leukemia can be linked with medium-sized vessel vasculitis such as polyarteritis nodosa
• Severe joint pain can result from acute leukemia. Leukemic arthritis occur in 5% of acute leukemia cases and complicates the disease
• Myelodysplastic syndromes can have rheumatic manifestations including:
• Cutaneous vasculitis
• Lupus-like syndromes
• Neuropathy and
• Episodic intense arthritis
• Painfully warm and reddened extremities – erhythromelalgia – is manifestation of meyloproliferative diseases, particularly essential thrombocythemia . Unlike Raynaud’s phenomenon, exposure to cold or elevating extremities can relieve pain
• Neurogenic Arthropathy: represents joint destruction characterized by loss or diminution of proprioception (inability to clearly identify position of body parts), pain, and temperature perception:
• It is frequently observed in diabetic neuropathy (foot and ankle joint involvement) or syringomyelia (involving the shoulder joints) and as pain in the knees of patients with tabes dorsalis  
• Loss of normal muscle tone and protective reflexes will proceed to secondary degenerative joint disease resulting in an enlarged, boggy, and relatively painless joint with:
• Extensive cartilage erosion
• Osteophyte formation and
• Multiple loose joint bodies
• X-rays can show osteolysis that resemble osteomyelitis or extensive destruction of the joint with:
• Subluxation
• Bone fragmentation and
• Bone sclerosis
• Treatment focuses on the primary disease:
• Mechanical support may be required to improve weight-bearing and prevent further damage to affected joints and
• In few cases, amputating the limb may be the only viable option 
• Palindromic Rheumatism: is a joint disease of unknown cause characterized by frequent acute inflammatory attacks in joints:
• Soft tissue pain with swelling – periarticular pain – and subcutaneous nodules
• Attacks can last between several hours and several days
• Palindromic rheumatism often affect knee and finger joints but any peripheral joint can be affected
• Fever is the only systemic symptom of palindromic rheumatism
• Palindromic rheumatism does not cause permanent joint damage, despite frequency of attacks
• Palindromic rheumatism should be distinguished from other articular disorders with similar manifestation – gouty arthritis and rheumatoid arthritis
• Treatment is symptomatic. Non-steroidal anti-inflammatory drugs (NSAIDs) are used to this end. Hydroxychloroquine can prevent recurring attacks
• Osteonecrosis (Avascular Necrosis of Bone or Kienbok’s Disease): it is a complication of corticosteroid use, trauma, systemic lupus erythematous, gout, sickle cell disease, dysbaric syndrome (the bends), knee menisectomy, and infiltrative diseases (Gaucher’s disease). The disease cause death of lunate bone tissues:
• Osteonecrosis of the wrist most commonly affect people employed in manual labor
• Symptoms of wrist pain sets in, around the area where the lunate bones reside – base of the wrist at its midpoint, with gradual wrist swelling and stiffening
• Osteonecrosis of the wrist initially affects one hand and eventually progress to the other hand. 10% of osteonecrosis of the wrist involve both hands
• It affects proximal and distal femoral heads much more frequently, and cause knee or hip pain
• It can also affect the ankles, shoulder, and elbow joints
• Diagnosis is based on magnetic resonance imaging (MRI), computed tomography (CT scans), and x-ray evidence. In its early stage of development, x-ray investigation might return normal
• Treatments of Kienbok’s disease consists of:
• Avoiding weight bearing on the affected joint for several weeks
• in few cases surgical core decompression can be beneficial
• Both vascularized and non-vascularized bone grafting techniques can be used to treat osteonecrosis of the hip and preserve the femoral head
• The procedures can help young patients avoid or forestall total hip arthroplasty
• Without treatment avascular necrosis of the bone can progress and bony infarction can advance to cortical collapse, resulting in significant joint dysfunction
• Total hip replacement is the usual end-stage treatment for all eligible patients