Advanced osteonecrosis - sickle cell disease

Case contributed by Fakhry Mahmoud Ebouda
Diagnosis probable

Presentation

Patient suffering from sickle cell disease.

Patient Data

Age: 22 years
Gender: Male

Right femoral and left humeral head deformities are seen. Irregularities, sclerosis mixed with lucencies are seen. An associated femoral neck deformity is seen. Radiographic findings are matching with avascular necrosis of the corresponding femoral as well as humeral heads. Crescent sign of avascular necrosis is seen on conventional radiographs, and seen as a linear area of subchondral lucency depicted usually within the anterolateral aspect of the proximal femoral head.

Case Discussion

Avascular necrosis is a process that results from interruption of blood supply to the bone. Etiopathogenesis is incompletely understood. Sickle cell anemia is a common cause that compromise circulation to either femoral or humeral heads. Osteonecrosis of the humeral head (ONHH) (also known as Hass disease).

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