Bilateral osteonecrosis of the femoral head after pregnancy.
Published cases of non-traumatic avascular necrosis of the femoral head associated with pregnancy are rare. We report a case of a 41-year-old woman who suddenly complained of bilateral hip pain 3 weeks after delivery by Caesarean section. For a problem of sterility, she had been treated with human menopausal gonadotropin and human chorionic gonadotropin (hMG-hCG). Initial radiographs of both hip joints were considered regular. After 4 years' evolution, radiographs of the hip joint showed collapse of both femoral heads. Bilaterally, osteonecrosis of the femoral heads was confirmed by MRI. MRI revealed a band pattern of low signal intensity for both hips on T1- and T2-weighted images. She had no history of steroid therapy or alcohol abuse. Osteonecrosis was related to pretentaine. A bilateral total hip arthroplasty was performed. The literature about avascular necrosis of the femoral head associated with pregnancy in previous cases is reviewed.
Vandenbussche
Eric
E
Department of Orthopaedic Surgery, Georges Pompidou European Teaching Hospital, Necker University, 20 Rue Le Blanc, 75908 Paris Cedex 15, France. eric.vdb@egp.ap-hop-paris.fr
Madhar
Mohamed
M
Nich
Christophe
C
Zribi
Wassim
W
Abdallah
Tarek
T
Augereau
Bernard
B
D000328:Adult; D019644:Arthroplasty, Replacement, Hip; D006063:Chorionic Gonadotropin / Q000627:therapeutic use; D005260:Female; D005271:Femur Head Necrosis / Q000175:diagnosis* / Q000601:surgery; D005300:Fertility Agents, Female / Q000627:therapeutic use; D006621:Hip Joint / Q000503:physiopathology*; D006801:Humans; D007247:Infertility, Female / Q000188:drug therapy; D008596:Menotropins / Q000627:therapeutic use; D010146:Pain / Q000503:physiopathology*; D049590:Postpartum Period / Q000502:physiology*; D011247:Pregnancy
D006063:Chorionic Gonadotropin; D005300:Fertility Agents, Female; D008596:Menotropins