Multifocal avascular necrosis after short-term high-dose steroid therapy. A report of three cases.
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.
D000328:Adult; D003907:Dexamethasone / Q000009:adverse effects*; D005270:Femur Head / Q000473:pathology / Q000601:surgery; D006622:Hip Prosthesis; D006801:Humans; D006811:Humerus / Q000473:pathology / Q000601:surgery; D007592:Joint Diseases / Q000209:etiology; D008297:Male; D010020:Osteonecrosis / Q000139:chemically induced*; D013997:Time Factors
D003907:Dexamethasone