Steroid induced avascular necrosis of bones in eighteen sites: a case report

A patient with idiopathic thrombocytopenia purpura who was treated with high dosage corticosteroids for ten years, developed 18 separate lesions of avascular necrosis in 12 different bones. Despite spontaneous revascularization of many of the lesions, subchrondral collapse caused symptomatic secondary degenerative arthritis in many joints. Pathological examination of both resected femoral heads showed no intravascular thrombosis.