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Avascular necrosis of the hips

Case contributed by J. Ray Ballinger
Diagnosis certain

Presentation

History of steroid use for Crohn Disease.

Patient Data

Age: 45 years
Gender: Male

Note: This case has been tagged as "legacy" as it no longer meets image preparation and/or other case publication guidelines.

The left hip shows the "double-line sign" that is characteristic of avascular necrosis (AVN); a hypointense line adjacent to a hyperintense line. The right hip shows extensive hypointensity and deformity of the femoral head in keeping with sclerosis and mild subchondral collapse.

Case Discussion

Avascular necrosis is usually secondary to vascular obstruction and commonly involves the hips. Predisposing conditions to AVN include steroid use (as in this case), pancreatitis, alcoholism, sickle cell disease, rheumatoid arthritis, and systemic lupus erythematosus.

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