Avascular necrosis - hip joint

Case contributed by Dr Zeeshan Ghias Khan

Presentation

Patient presented with bilateral hip pain. Patient had history of steroids use.

Patient Data

Age: 55 years
Gender: Male
X-ray

Frontal pelvic radiograph shows marked flatening and sclerosis of both femoral heads representing advanced (Ficat stage III) avascular necrosis.

Case Discussion

Avascualr necrosis (AVN), also called osteonecrosis or aseptic necrosis, is a condition that occurs when there is loss of blood to the bone. The femoral head is the most common location for AVN to occur.

Etiology 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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Case information

rID: 66041
Published: 5th Feb 2019
Last edited: 1st Jun 2020
Tag: hip, avn
Inclusion in quiz mode: Included
Institution: Pakistan institute of medical sciences, islamabad, Pakistan

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