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Avascular necrosis

Case contributed by Melbourne Uni Radiology Masters
Diagnosis certain

Presentation

Bone pain.

Patient Data

Age: 19-year-old
Gender: Female

Left hip and pelvis X-ray

x-ray

The left femoral head is sclerotic and irregular margins, appearances are consistent with avascular necrosis with regions of subchondral collapse. There s subchondral sclerosis in the acetabulum with osteophyte formation indicating developing osteoarthritis. The right femoral head appears sclerotic but has preserved normal contours. Appearances are suspicious for avascular necrosis here also. The medulla of the left femoral diaphysis has a striated appearance. There are no definite features to suggest medullary infarcts. Knee joint unremarkable.

Right shoulder X-ray

x-ray

There are changes of avascular necrosis present involving the articular and subarticular portion of the humeral head.

Case Discussion

Steroid induced avascular necrosis is present as a result of prior treatment for AML.

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