Does the Necrosis Develop Simultaneously in Patients with Bilateral Hips Necrosis? A Case Report

摘要

Osteonecrosis of the femoral head (ONFH), also known as avascular necrosis of the femoral head, is a debilitating disease that affects relatively young and active patients. It is defined as the cell death of marrow and mineralized bone, and represents the final pathway of several disease conditions. Among various known causes, steroid therapy is responsible for a significant majority of these cases. More than half of corticosteroid-induced osteonecrosis affects both femoral heads; bilateral ONFH is considered to develop simultaneously. Only one case study has reported development of contralateral ONFH after increasing the dose of corticoste-roid. To our knowledge, no reports have focused on the time course over which this condition develops in both hips after brief pulse treatment with steroids. We here describe a case of ONFH after steroid therapy in which serial MRI imaging revealed asynchronous development of bilateral lesions. The study was approved by the institutional review board (IRB) and informed consent was obtained from the patient.