Simultaneous Bilateral Avascular Necrosis of the Femoral Heads Associated With Cocaine Use

El-Yahchouchi, Christine; Moussa, Mohamad; Khalaf, Zaynab; Moussallem, Charbel D.

doi:10.7759/cureus.9865

Cited by 3 publications

(2 citation statements)

References 15 publications

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“…3,4 Other risk factors include genetics, vasculitis, hyper coagulopathy, cocaine use, and micro emboli. 5 While idiopathic AVN of the hip accounts for around 20% of cases, 3,4 femoral head osteonecrosis is rarely associated with pregnancy. AVN of the hip associated with pregnancy has been linked to a number of pathophysiological mechanisms, but none of them have been proven to be the sole contributing factor.…”

Section: Discussionmentioning

confidence: 99%

Case Report: Idiopathic avascular necrosis of the femoral head following pregnancy

Suryadevara,

Mishra,

Parihar

et al. 2023

F1000Res

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Background: Hip pain during pregnancy is very common, but avascular necrosis (AVN) represents a very rare entity. Osteonecrosis of the head of the femur during the pregnancy, or shortly after the pregnancy, is a rare clinical problem. Little is known about pregnancy as an etiological factor for AVN of the femoral head. Case: In this case report, a documented case of femoral head osteonecrosis, a rare complication after pregnancy is presented. The patient presented with complaints of pain in the left hip that gradually worsened and led to restriction of movement. The patient was advised an X-ray, which showed a fracture of neck of the left femur, and an MRI following the X-ray revealed features of AVN of the hip. The patient was later taken for total hip arthroplasty, which was uneventful. On follow-up, the patient had relief from her symptoms and had no complications. Alcoholism, steroid use, systemic lupus erythematosus, organ transplantation (particularly following kidney or bone marrow transplantation), dyslipidemia (particularly hypertriglyceridemia), Gaucher disease, decompression sickness, and drepanocytosis are known risk factors for osteonecrosis. We can list pro-coagulation abnormalities, chemotherapy, and HIV among the less established factors. Here, we present a case of a patient with postpartum AVN of the femoral head that suffered AVN of the left hip in the post-partum period, her symptom of hip pain was neglected as a benign cause initially, which led to aggressive treatment (total hip arthroplasty) at a young age. Conclusions: Having high suspicion of the diagnosis of AVN and a low threshold for magnetic resonance imaging (MRI) imaging in a pregnant woman with hip pain is a requirement to avoid complications. This case highlights the need for high suspicion of osteonecrosis as a cause of hip pain in the post-partum period.

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Section: Discussionmentioning

confidence: 99%

Case Report: Idiopathic avascular necrosis of the femoral head following pregnancy

Suryadevara,

Mishra,

Parihar

et al. 2023

F1000Res

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“…Corticosteroids and alcohol intake are the most common atraumatic cause of hip osteonecrosis [3] , [5] . Other risk factors include hypercoagulopathy, microemboli, vasculitis, genetics and cocaine use [6] . While idiopathic cause of hip avascular necrosis accounts for a large entity around 20% [3] , [5] , pregnancy as a risk factor for hip avascular necrosis has not yet been established well, it has been cited in the literature with several case reports and only small series, the largest one of 13 cases reported by Montella et al in 1999 [7] .…”

Section: Discussionmentioning

confidence: 99%

Hip avascular necrosis in a healthy pregnant woman: A case report and review of literature

Mouchantaf

Freiha

Moussa

et al. 2021

International Journal of Surgery Case Reports

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Background Hip pain during pregnancy is very common, but hip avascular necrosis represents a very rare entity. Case report We report a rare case of a healthy30-year-old female patient pregnant with twins, that suffered right hip avascular necrosis in the peripartum period, her symptoms were initially neglected as a benign cause of hip pain, this led to aggressive treatment at a young age. Discussion With less than 100 cases reported in the literature, pregnancy is not a well-known risk factor for femoral head avascular necrosis and it should be differentiated from one of the more common hip pathologies in pregnancy which is the so-called “Pelvic pain syndrome” and transient osteoporosis of the hip. Conclusion Having a high index of suspicion and low threshold for MRI imaging in a pregnant woman with hip pain is a must to prevent such complications.

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The effect of cocaine on patients undergoing total hip arthroplasty

Venishetty¹,

Nguyen²,

Sohn³

et al. 2023

Journal of Orthopaedics

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Simultaneous Bilateral Avascular Necrosis of the Femoral Heads Associated With Cocaine Use

Cited by 3 publications

References 15 publications

Case Report: Idiopathic avascular necrosis of the femoral head following pregnancy

Case Report: Idiopathic avascular necrosis of the femoral head following pregnancy

Hip avascular necrosis in a healthy pregnant woman: A case report and review of literature

The effect of cocaine on patients undergoing total hip arthroplasty

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