The Daily Grind: A Woman with Neuropathy and Memory Impairment

She had undergone left total hip arthroplasty 20 years ago, with later acetabular liner failure that led to a revision arthroplasty. Laboratory evaluation was notable for polycythemia, hyperglycemia, and thyroid dysfunction. There were radiopaque deposits in the periarticular soft tissue of her hip on x-ray (Figure 1). Review of surgical records showed that her recent hip revision involved implantation of a cobalt-chromium femoral head, leading her physicians to pursue testing for cobalt toxicity as the cause of her multisystemic disease.