Multifocal avascular necrosis after short-term high-dose steroid therapy. A report of three cases

J Bone Joint Surg Br. 1984 May;66(3):431-3. doi: 10.1302/0301-620X.66B3.6725356.

Abstract

Avascular necrosis of bone is a well-recognised phenomenon in patients on long-term steroid therapy, especially after renal transplantation. There are only four cases reported in the literature of multifocal avascular necrosis after short-term high-dose steroid therapy, and three additional cases are reported in this paper. All the hips have needed reconstructive surgery within two and a half years of the onset of symptoms; in one patient, however, this has been prevented by other medical problems. In two of the three patients reported in this paper the shoulders also were affected; eventually they became pain-free but movement was restricted. Short-term high-dose steroid therapy has only recently been recognised as a cause of avascular necrosis and attempts should be made to prevent the incidence increasing.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Dexamethasone / adverse effects*
  • Femur Head / pathology
  • Femur Head / surgery
  • Hip Prosthesis
  • Humans
  • Humerus / pathology
  • Humerus / surgery
  • Joint Diseases / etiology
  • Male
  • Osteonecrosis / chemically induced*
  • Time Factors

Substances

  • Dexamethasone