Avascular necrosis - hip joints

Case contributed by Dr Bahman Rasuli

Presentation

Bilateral hip pain with the history of steroid use.

Patient Data

Age: 20 years
Gender: Male
X-ray

Frontal pelvic radiograph shows marked 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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Case information

rID: 66559
Published: 28th Feb 2019
Last edited: 2nd Mar 2019
Inclusion in quiz mode: Included
Institution: Jame Jam Imaging Center

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