Humeral head and femoral head osteonecrosis due to sickle cell disease

Case contributed by Dr Yair Glick

Presentation

Abdominal pain in a patient with sickle cell disease.

Patient Data

Age: Young adult
Gender: Male

Subchondral lucencies with a sclerotic rim in both humeral heads.

Focal cortical collapse at the superior aspect of the right femoral head, with a small subchondral lucency and prominent surrounding sclerosis (Steinberg stage IV). There is sclerosis of the acetabular roof. No joint space narrowing appreciated.

Other than the above, the chest and abdominal x-rays are normal.

Case Discussion

Bilateral humeral head necrosis and right femoral head necrosis in a sickle cell disease patient.
No other abnormal findings on the chest or abdominal x-rays. The abdominal pain could have been due to a sickle cell crisis.

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