Bilateral humeral head avascular necrosis

Case contributed by Dr Jeremy Jones

Presentation

Bilateral shoulder pain. No recent trauma. History of ALL.

Patient Data

Age: 40 years
Gender: Female

The medial joint surfaces of both humeral heads are flattened with increased sclerosis. There is reduced joint space. The glenoid is normal.

Case Discussion

Bilateral humeral head avascular necrosis following chemotherapy treatment in a patient with ALL. Chemotherapy regimes with high dose steroids are associated with an increased incidence of avascular necrosis. This often affects the femoral heads. In this case, slightly unusually, the humeral heads are affected.

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