Inflammatory Arthritis Uncovered Through Imaging of Osteonecrosis: A Case Series

Osteonecrosis (ON) is typically viewed as an isolated condition stemming from vascular compromise. We present a three-case series demonstrating that MRI, performed to confirm the diagnosis of ON, incidentally revealed features consistent with underlying, previously undiagnosed inflammatory arthritis (IA). Even in the absence of typical clinical features, the presence of imaging findings such as synovitis, tenosynovitis, and erosions should prompt a thorough clinical and serological evaluation for coexisting IA. An interesting point to note is that none of the three patients reported a history of steroid use. This manuscript aims to highlight a possible pathophysiological link between IA and ON.