Presentation
History of steroid use.
Patient Data
Age: 25 years
From the case:
Avascular necrosis - hip joints
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Frontal pelvic radiograph shows flatening and sclerosis of both femoral heads representing advanced avascular necrosis (Ficat stage IV).
Case Discussion
The femoral head is the most common location for AVN to occur. Etiology of the avascular necrosis can be remembered by the following mnemonic:
GIVE INFARCTS
- Gaucher disease
- Idiopathic (Legg-Calvé-Perthes, Köhler, Chandler)
- Vasculitis (SLE, polyarteritis nodosa, rheumatoid arthritis)
- Environmental (frostbite, thermal injury)
- Irradiation
- Neoplasia (associated coagulopathy)
- Fat (prolonged corticosteroid use increases marrow)
- Alcoholism
- Renal failure and dialysis
- Caisson disease
- Trauma (femoral neck fracture, hip dislocation)
- Sickle cell disease
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