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Steroid-induced osteonecrosis in refractory ulcerative colitis.
Kenichi Ito1, Mieko Inuo-Nakayama, Masahiro Matsumoto
1Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan.
Fukuoka Igaku Zasshi = Hukuoka Acta Medica
|April 21, 2005
Summary
This case study highlights steroid-induced osteonecrosis in a patient with refractory ulcerative colitis. Bone MRI is an excellent tool for early diagnosis of osteonecrosis, aiding treatment decisions.
Area of Science:
- Orthopedics
- Gastroenterology
- Radiology
Background:
- Ulcerative colitis (UC) is a chronic inflammatory bowel disease.
- Long-term corticosteroid therapy is common in refractory UC.
- Corticosteroids can lead to various side effects, including bone complications.
Observation:
- A 31-year-old woman with a ten-year history of refractory UC presented with acute right knee pain and swelling.
- Conventional radiography did not show osteoporosis or fracture.
- Magnetic resonance imaging (MRI) revealed characteristic changes in the femur and tibia.
Findings:
- The MRI findings were consistent with steroid-induced osteonecrosis.
- Bone MRI, utilizing T1-, T2-, and T2*-weighted images, identified irregular heterogeneous areas of low- and high-intensity signals.
- These imaging findings were crucial for diagnosing osteonecrosis.
Implications:
- This case underscores the risk of osteonecrosis with prolonged corticosteroid use in UC patients.
- Early and accurate diagnosis of osteonecrosis is critical for effective management.
- Bone MRI is a valuable diagnostic modality for detecting early-stage osteonecrosis.