Sickle cell disease: hip avascular necrosis and H-shaped vertebrae

Case contributed by Dr Jan Frank Gerstenmaier

Presentation

This patient presented with bilateral hip pain

Patient Data

Age: 25 years old
Gender: Female

There is flattening of the left femoral head indicating cortical collapse. Appearances are typical for avascular necrosis.

Multilevel endplate collapses are shown in the dorsal spine and upper lumber spine in keeping with microvascular endplate infarcts, giving a typical H-shaped appearance to the vertebral bodies.

Case Discussion

H- shaped vertebrae are seen in around 1 in 10 patients with sickle cell disease. AVN of the hip is more common and occurs in 1/3 of patients.  Both H-shaped vertebrae and hip AVNs are seen in 3% or patients.

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