[Aseptic femur head osteonecrosis during treatment of acute lymphoblastic leukemia in the child].
Avascular femoral head necrosis (AFN) is an uncommon complication of acute lymphoblastic leukemia (ALL) occurring in association with serious functional late effects. One of the many risk factors is high-dose corticosteroid therapy.


METHODS
Three children belonging to a series of 266 patients developed AFN. The diagnosis was not made immediately when X-rays were normal. In spite of the fact that treatment was begun as soon as possible, the three children had a difference in the length of their legs, with reduction of their walking perimeter and, in one case, an arthroplasty was necessary.


CONCLUSIONS
If some patients treated for ALL limp or suffer when walking or when practising sports, the diagnosis of AFN is to be evoked. The diagnosis is not only based on simple X-rays but also on magnetic resonance imaging, which is more sensitive and reveals lesions earlier. The treatment consists of immobilization of the hip, whether or not associated with surgical procedures.
Beguin
A
A
Service d'hématologie pédiatrique, Hôpital Debrousse, Lyon, France.
Bertrand
Y
Y
Ourcival
S
S
Foray
P
P
Manel
A M
AM
Philippe
N
N
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000009:adverse effects*; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D002648:Child; D005260:Female; D005270:Femur Head / Q000187:drug effects / Q000473:pathology; D005271:Femur Head Necrosis / Q000139:chemically induced* / Q000175:diagnosis; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy*
D000305:Adrenal Cortex Hormones; D000970:Antineoplastic Agents