Osteonecrosis of humeral and femoral heads

Case contributed by Utkarsh Kabra
Diagnosis certain

Presentation

Pain with restriction of motion

Patient Data

Age: 50 years
Gender: Male

Right shoulder joint

mri

Serpiginous peripheral /outer dark (sclerosis) and inner bright (granulation tissue) on T2WI in the proximal humeral head (double line sign) with areas of subchondral collapse and surrounding marrow edema.

Lt shoulder & biLat hip joints

mri

Screening of contralateral shoulder and hip joints also shows avascular necrosis of bilateral femoral heads and left humeral head.

Case Discussion

Findings show osteonecrosis/avascular necrosis of both humeral and femoral heads. Possible causes include steroid, alcohol intake, sickle cell anemia or other hematological disorders(details not known in this case).

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