Avascular necrosis (AVN) of the femoral head is a well-recognized complication of steroid treatment. Exogenous glucocorticoids’ administration and alcoholism are the most common nontraumatic etiologies. AVN secondary to endogenous hypercortisolism (HC) is rare; very few case reports are available on this complication. We describe a 28-year-old female that has presented an AVN with Cushing's syndrome. Biochemical investigations confirmed HC. Magnetic resonance imaging (MRI) showed a pituitary adenoma that was resected transsphenoidally. The postoperative failure directed to radiosurgery treatment. Then, the patient then expressed a significant clinical improvement while developing adrenocorticotropic deficiency; hence, steroids were indicated. During the discovery of Cushing disease, the patient presented also limping and progressive pain in right hip. The pelvis MRI showed an AVN of the right femoral head. The patient underwent a total replacement of the right hip sine presenting an extensive AVN. This case elucidates that AVN could be an early manifestation of Cushing's disease.
Les anomalies du développement décrites dans le syndrome de Williams, associent classiquement une dysmorphie, des malformations cardiovasculaires et un profil neuropsychologique particulier et d'autres troubles associés. Nous rapportons le cas d'une jeune fille âgée de 17 ans, issu d'un mariage non consanguin, chez qui le syndrome de Williams a été découvert suite à une exploration dans le cadre du bilan d'un retard staturo-pondéral. L'association a une insuffisance surrénalienne primitive en fait la singularité. La confirmation diagnostique avait nécessité une analyse cytogénétique et moléculaire. La prise en charge consistait à la mise en route de traitement pour l'insuffisance surrénalienne associé à une surveillance clinico-biologique.
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