[Avascular necrosis of both hips and knees in a patient with ulcerative colitis treated for a long term with high-dose corticosteroids].
BACKGROUND
Avascular necrosis represents the bone tissue death from vascularization failure, and it is mainly associated with the use of high-dose corticosteroids for a long time.


METHODS
A 25 years old female patient treated with high-dose corticosteroids for 7 months for ulcerative colitis presents with both knees pain and limited hip and knee motility. In a plain X-ray and in nuclear magnetic resonance imaging (MRI) avascular necrosis was observed at these joints. Bone densitometry showed osteopenia at the femoral head and lumbar osteoporosis.


CONCLUSIONS
We present a striking case for its large involvement of the joints (both knees and hips) with simultaneous osteoporosis and osteopenia in a young patient treated with corticosteroids for ulcerative colitis. It is necessary to recommend the judicious use of glucocorticoids, prescribing the minimal necessary dose and for the least amount of time necessary to control the underlying disease.
Vidal Casariego
A
A
Unidad de Nutrición Clínica y Dietética, Hospital General Universitario Gregorio Marañón, Madrid, España. avcyo@mixmail.com
de la Cuerda Compés
C
C
Bretón Lesmes
I
I
Camblor Alvarez
M
M
Velasco Gimeno
C
C
García Peris
P
P
D000328:Adult; D003093:Colitis, Ulcerative / Q000188:drug therapy*; D005260:Female; D005271:Femur Head Necrosis / Q000139:chemically induced; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D007719:Knee Joint; D008775:Methylprednisolone / Q000008:administration & dosage / Q000009:adverse effects*; D010020:Osteonecrosis / Q000139:chemically induced*; D013997:Time Factors
D005938:Glucocorticoids; D008775:Methylprednisolone