Association Between Hip Radiographic Parameters and Osteonecrosis Severity in Sickle Cell Disease: A Pilot Study

In this pilot study, we analyzed whether there is an association between hip radiographic parameters and the severity of osteonecrosis secondary to sickle cell disease, according to the Ficat and Arlet, and Ohzono classifications.

This descriptive cross-sectional study included 20 patients aged 18 to 45 years treated at Professor Edgard Santos University Hospital (HUPES). All patients underwent an anteroposterior pelvic radiograph at HUPES. Clinical and radiographic data were collected, including the classification of osteonecrosis according to Ficat and Arlet, and Ohzono, as well as the following radiographic parameters: position of the hip center, femoral head extrusion index, Wilberg angle, Tönnis acetabular roof angle, and cervicodiaphyseal angle.

Seven hips were excluded because they had already undergone surgical treatment. Of the 33 hips evaluated, most were in advanced stages of osteonecrosis. The cervicodiaphyseal angle showed a significant difference between advanced stages (III and IV) and early stages (IIA and IIB) in the Ficat & Arlet classification, while other parameters did not present statistically significant differences.

The study identified significant variations in the cervicodiaphyseal angle between different stages of osteonecrosis. Despite being limited by the small sample size and excluding post-surgical cases, the study provides an initial basis for the radiographic characterization of osteonecrosis associated with Sickle Cell Disease. It indicates the need for future research with larger samples.