Coincidence of asymptomatic avascular necrosis and fracture of the femoral neck: a rare combination of glucocorticoid induced side effects

Loddenkemper, K.

doi:10.1136/ard.61.7.665

Cited by 7 publications

(5 citation statements)

References 7 publications

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“…Various pre-existing conditions or risk factors have been described to be associated with ONFH that eventually resulted in SSF. Corticosteroid use has been associated in 10 out of 28 reported patients (3,4,6,8,10,12,14). It is evident that these steroid prescriptions were medically indicated in all these reports.…”

Section: Discussionmentioning

confidence: 92%

“…Regarding fracture terminology : There exists a diversity in description of this fracture that develops in the setting of extensive ONFH (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15). A stress fracture may be defined as a complete or incomplete Table I.…”

Section: Discussionmentioning

confidence: 99%

“…Description : ONFH presenting with SSF is being recognised as a separate entity, though the presentation remains rare. Thorough literature search yielded 23 such reports, 13 in English language (Table II) (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(21)(22)(23)(24), 8 in Japanese, and one each in Dutch and French. The reports other than English language based medical literature were excluded from the review.…”

Section: Discussionmentioning

confidence: 99%

“…Spontaneous subcapital fracture (SSF) of femoral neck complicating ONFH is an uncommon presentation and only a few cases have been reported so far (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15). These reports largely present unilateral subcapital SSF of the femoral neck, with femoral head in various stages of osteonecrosis (3)(4)(5)(6)(7)(11)(12)(13)(14)(15).…”

Section: Introductionmentioning

confidence: 99%

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Spontaneous subcapital femoral neck fracture complicating osteonecrosis of femoral head

Arora¹,

Kumar²,

Khan³

et al. 2021

Acta Orthop Belg

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Spontaneous subcapital fracture (SSF) of femoral neck in pre-existent osteonecrosis of femoral head (ONFH) is a rare presentation. Only a few cases have been reported so far and majority of them have been reported to have unilateral hip involvement. We retrospectively reviewed clinical-radiological data of 10 patients (12 hips) with SSF complicating ONFH. All of them underwent uncemented total hip arthroplasty. All the available publications in the English language based medical literature were critically reviewed and results were summarized. The median age of presentation was 32 years (range : 24 years to 61 years). They were followed up for a mean duration of 25 months (range : 12 months to 59 months). The most common risk factor was corticosteroid consumption (7 out of 10 patients). All except one (modified Ficat and Arlet stage II) belonged to advanced stage of ONFH {stage III 3 patients (3 hips), stage IV 6 patients (8 hips)}. The mean time lag of ONFH to presentation was 22.3 months (range : 5 months to 60 months), and SSF to presentation was 13.8 days (range : 1 day to 28 days). Mean pre- operative Harris Hip Score was 10.8 (range : 8 to 14), which improved to 93 (range : 91 to 96) after total hip arthroplasty when last followed up (p<0.05). Corticosteroids induced ONFH has a propensity to develop SSF. This entity should find a place in existing classification system.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Spontaneous subcapital femoral neck fracture complicating osteonecrosis of femoral head

Arora¹,

Kumar²,

Khan³

et al. 2021

Acta Orthop Belg

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“…We examined the possible combination of these two disease entities and found only steroid-induced osteoporosis (36) and steroid-induced osteonecrosis (37). However, the combination appears to be rare and only case report was found (38).…”

Section: Discussionmentioning

confidence: 99%

Proton MR spectroscopy of the femoral head—Evaluation of patients at risk for avascular necrosis

Hou

Shih

Liu

et al. 2006

Magnetic Resonance Imaging

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Purpose: To detect alteration of the fatty component by measuring the in vivo lipid and water content of normal-looking femoral heads of patients with and without risk for avascular necrosis (AVN) by using proton MR spectroscopy (MRS). Materials and Methods:Marrow composition was measured by proton MRS (TR/TE ϭ 5000/20 msec) in a sample volume placed in the epiphysis of the intact femoral heads of patients with unilateral osteonecrosis of the hip (group 1, N ϭ 61, then excluding the post-traumatic or steroid user, final N ϭ 45) and age-matched controls (group 2, N ϭ 49). Three response variables were derived from MRS: the lipid linewidth (LW), water LW, and lipid/water ratio. Results:Of the three variables, the lipid and water LWs differed significantly between groups (P Ͻ 0.001 and P ϭ 0.05, respectively; t-test). The lipid/water ratio had borderline significance (P ϭ 0.06). The three variables differed significantly between groups when multivariate regression (P Ͻ 0.0001) was analyzed; and age and sex had no significant effect on the three dependent variables. Conclusion:Proton MRS can depict alteration in the lipid and water composition of normal-looking femoral heads with and without AVN on the contralateral hip. Proton MRS may be a potential tool for investigating of the femoral head component in vivo and predicting the risk for development of AVN.

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Current Awareness: Pharmacoepidemiology and Drug Safety

2002

Pharmacoepidemiology and Drug

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In order to keep subscribers up‐to‐date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of pharmacoepidemiology and drug safety. Each bibliography is divided into 19 sections: 1 Books, Reviews & Symposia; 2 General; 3 Anti‐infective Agents; 4 Cardiovascular System Agents; 5 CNS Depressive Agents; 6 Non‐steroidal Anti‐inflammatory Agents; 7 CNS Agents; 8 Anti‐neoplastic Agents; 9 Haematological Agents; 10 Neuroregulator‐Blocking Agents; 11 Dermatological Agents; 12 Immunosuppressive Agents; 13 Autonomic Agents; 14 Respiratory System Agents; 15 Neuromuscular Agents; 16 Reproductive System Agents; 17 Gastrointestinal System Agents; 18 Anti‐inflammatory Agents ‐ Steroidal; 19 Others. Within each section, articles are listed in alphabetical order with respect to author. If, in the preceding period, no publications are located relevant to any one of these headings, that section will be omitted.

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Coincidence of asymptomatic avascular necrosis and fracture of the femoral neck: a rare combination of glucocorticoid induced side effects

Abstract: Figure 1 CT scan of the thorax showing marked pericardial effusion (arrow) and bilateral pleural effusions (left greater than right) (arrow): mediastinal windows.

Cited by 7 publications

References 7 publications

Spontaneous subcapital femoral neck fracture complicating osteonecrosis of femoral head

Spontaneous subcapital femoral neck fracture complicating osteonecrosis of femoral head

Proton MR spectroscopy of the femoral head—Evaluation of patients at risk for avascular necrosis

Current Awareness: Pharmacoepidemiology and Drug Safety

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