Presentation
We report a 30-yr-old woman with Cushing's disease whose presenting manifestation was early AVN of the hip. Although plain x-ray was negative, magnetic resonance imaging (MRI) of the hip showed stage 2 AVN. [ncbi.nlm.nih.gov]
Entire Body System
- Collapse
Abstract The natural history of untreated nontraumatic avascular necrosis of the femoral head has a very poor outcome because of the high percentage of collapse of the head. [ncbi.nlm.nih.gov]
The extent and location of femoral head necrosis on MRIs have been studied as predictors of femoral head collapse. [iqb.es]
Among the seven 2B hips, four were converted to a total hip prosthesis and two femoral heads collapsed. At mean follow-up (3.5 years), 69% of the hips had not required total hip arthroplasty. [mg-consulte.com]
Collapse all Expand all Contexte La nécrose avasculaire des os est une complication fréquente et grave de la drépanocytose et son traitement n'est pas standardisé. [cochranelibrary.com]
Musculoskeletal
- Hip Pain
Two weeks later she described left knee and left hip pain. On physical examination, motion in her left knee and hip was severely painful without inflammation but range of motion was not limited. [ncbi.nlm.nih.gov]
Disponible en: https://www.uptodate.com/contents/approach-to-hip-pain-in-childhood?search=approach-to-hip-pain-in-childhood Lespasio MJ, Sodhi N, Mont MA. Osteonecrosis of the Hip: A Primer. [revistamedicasinergia.com]
[…] to rule out other conditions that may cause hip pain (eg, rheumatoid arthritis). [iqb.es]
Treatment
[…] as morphological changes on femoral head, and to classify them with standard classification methods, and (3) to analyse the research results and make a recommendation for the following treatment dilemma: when is the optimal time for an operative treatment [ncbi.nlm.nih.gov]
Prognosis
AVN carries a poor prognosis, if not treated early. The diagnostic procedure of choice is MRI, because plain radiographs are falsely negative in early stages. [ncbi.nlm.nih.gov]
Etiology
Osteonecrosis of the Femoral Head: Etiology, Investigations, and Management. Cureus. 2018;10(8): e3171. https://doi.org/10.7759/cureus.3171 Tripathy SK, Goyal T, Sen RK. Management of femoral head osteonecrosis: Current concepts. [revistamedicasinergia.com]
Furthermore, if no obvious cause of AVN is seen, medical consultation would be a reasonable measure in order to help discern less common etiologies. (See Clinical, Causes, above.) [iqb.es]
Pathophysiology
Osteonecrosis of the femoral head: pathophysiology and current concepts of treatment. [revistamedicasinergia.com]
The pathophysiology of SCD has been reviewed extensively (Hebbel 2004; Steinberg 2006; Stuart 2004; Weatherall 2006). [cochranelibrary.com]
Prevention
This case illustrates that AVN can be the presenting manifestation of CS; to prevent irreversible effects on the femoral head, core decompression should not be delayed for the purpose of evaluation and treatment of CS. [ncbi.nlm.nih.gov]
Inhibition of the vascular endothelial growth factor may hold promise in preventing femoral head collapse because revascularization compromises bone structural integrity. [iqb.es]
There is an argument for early prevention and effective treatment for people with SCD with suspected AVN, but as yet no evidence base to support operative intervention. [cochranelibrary.com]