Aggressive and rapid progression of idiopathic bilateral avascular necrosis of femoral head in an old woman suffering from osteoporosis: A case report and review of the literature

作者：Fotiadis Elias^*; Gantsos Apostolos; Kenanidis Eustathios; Svarnas Theodoros; Filitantzi Crisa; Samoladas Efthimios; Chalidis Byron

来源：European Journal of Orthopaedic Surgery and Traumatology, 2011, 21(7): 535-538.

DOI：10.1007/s00590-010-0736-z

• Avascular necrosis
• Femoral head
• Osteoporosis
• Hemiarthroplasty

Background We present an unusual case of an aggressive and rapid progression of idiopathic bilateral avascular necrosis (AVN) of femoral head in an old woman suffering from osteoporosis.
Case presentation An 83-year-old woman with an unremarkable past medical history admitted to the Emergency Department of the Hospital with ongoing bilateral groin and buttock pain started a week ago. Clinical examination revealed painful hip movements with a slight limitation of joint range of motion. Anteroposterior radiographs demonstrated only osteoporosis of both hips without evidence of fracture or deformity. The patient was re-admitted to the Emergency Department 3 weeks afterwards with intractable bilateral groin pain and inability to walk. New X-Rays showed severe destruction and collapse of both femoral heads. The patient underwent cemented bipolar hemiarthroplasty in both hips. Histological examination established the diagnosis of AVN.
Conclusion This is the first case presented in English literature of such aggressive and rapid progression of bilateral idiopathic AVN. Due to the potential synergistic role of osteoporosis in the development of hip AVN, early MRI examination should be considered in patients with osteoporosis and acute hip pain.

• 出版日期2011-10