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Bilateral Avascular Necrosis of the Femoral Heads Secondary to Familial Hyperlipidemia
Thomas F Fusillo1,2, Michael Nguyen3
1Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, USA.
Insights
Avascular necrosis (AVN) can affect young adults, as seen in a case of hip pain caused by familial hyperlipidemia. Early diagnosis and hip replacement are crucial for managing this bone death condition.
Area of Science:
- Orthopedics
- Cardiology
- Genetics
Background:
- Avascular necrosis (AVN) is bone death due to disrupted blood supply, typically affecting children and older adults.
- While AVN can occur at any age, its presentation in young adults is less common but significant.
Observation:
- A previously healthy male in his mid-twenties presented with progressive hip pain.
- Imaging revealed severe femoral head collapse and marrow edema, indicative of advanced AVN.
Findings:
- The patient had severely elevated low-density lipoprotein (LDL) levels, leading to a diagnosis of AVN secondary to familial hyperlipidemia.
- Treatment involved total hip arthroplasty and high-intensity statin therapy.
Implications:
- This case underscores the importance of considering AVN in young adults presenting with hip pain.
- Prompt diagnostic workup and appropriate management, including addressing underlying lipid disorders, are essential for favorable outcomes.
Abstract:
Avascular necrosis (AVN) is a progressive disease characterized by bone death secondary to an interruption of the relevant vascular supply. While it is most common in pediatrics and later adulthood, it can occur at any age. This case describes a previously healthy man in his mid-twenties who presented with worsening hip pain. Imaging, including X-ray and magnetic resonance, revealed severe marrow edema and early collapse of the femoral head. The patient was also found to have a severely elevated low-density lipoprotein level, leading to the diagnosis of AVN due to familial hyperlipidemia. He received a total hip arthroplasty and was started on high-intensity statin therapy. This case highlights the importance of considering AVN in the young adult population with hip pain as well as the appropriate workup and treatment.
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