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Multifocal osteonecrosis after short-term high-dose corticosteroid therapy. A case report
1Department of Orthopedics Naval Hospital, San Diego, California 92134-5000.
Clinical Orthopaedics and Related Research
|June 1, 1992
Summary
Multifocal osteonecrosis, a rare complication, occurred after short-term methylprednisolone treatment for septic shock. This case highlights a potential risk even with brief corticosteroid use, leading to joint replacement surgery.
Area of Science:
- Orthopedics
- Endocrinology
- Pharmacology
Background:
- Osteonecrosis is a known complication of prolonged corticosteroid use.
- Septic shock often requires intensive medical treatment, including corticosteroids.
Observation:
- A patient developed multifocal osteonecrosis affecting both humeral heads and the left femoral head.
- Symptoms appeared two years after a two-week course of methylprednisolone for septic shock.
Findings:
- Radiographic and MRI evidence confirmed osteonecrosis in multiple joints.
- Conservative management was ineffective for the patient's joint pain and dysfunction.
Implications:
- Short-term methylprednisolone may pose a risk for osteonecrosis, challenging previous assumptions.
- This case underscores the need for vigilance regarding corticosteroid-induced avascular necrosis.
- Bipolar hip replacement was ultimately required due to treatment failure.