Widespread osteonecrosis - sickle cell disease

Case contributed by Bassem Marghany
Diagnosis almost certain


Chronic pain at multiple joints; known case of sickle cell disease.

Patient Data

Age: 30 years
Gender: Female

Medullary metaphyseal lesions at the distal femur and proximal tibia, showing serpiginous borders with double-line sign (bone infarcts).

Subchondral avascular necrosis (AVN) of the femoral condyles.

Shoulder joint


Subchondral avascular necrosis (AVN) of the humeral head.

Both hip joints


Subchondral avascular necrosis (AVN) of both femoral heads, with early structural collapse of the right femoral head.

Case Discussion

Sickle cell disease is one of the most common causes of widespread osteonecrosis including bone infarcts and subchondral AVN.

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