Iron Overload in Human Disease

To the Editor: We found two paradoxes in the review article by Fleming and Ponka on iron-overload disorders (Jan. 26 issue).¹ The first paradox is that musculoskeletal disorders that are caused by iron overload are rare, but musculoskeletal complications of iron-overload disorders are mostly common. The prevalence of joint pain was reported to be as high as 72.4% in patients with hereditary hemochromatosis,² and osteoporosis is also highly correlated with hereditary hemochromatosis.³ This paradox may so confuse both patients and orthopedists that a proper diagnosis is delayed, since the authors state that early diagnosis of iron overload requires consideration of . . .