Bilateral Avascular Necrosis of the Femoral Head After COVID-19 Infection: A Case Report

Yıl 2022, , 235 - 238, 31.08.2022

Alper Uysal , Merve Erdem Uysal

https://doi.org/10.29058/mjwbs.1054040

Cited By: 3

Öz

Aim: Avascular necrosis of the femoral head is a condition characterized by limited range of motion,
pain, and gait disturbance resulting from insufficient blood flow. We aim to evaluate the relationship
between COVID-19 and avascular necrosis.
Case: Herein, we present a 63-year-old male patient who developed avascular necrosis of the bilateral
femoral head after COVID-19.
Conclusion: COVID-19 infection alone and corticosteroids given to treat it can increase the incidence
of avascular necrosis of the femoral head. MRI of the hip is highly specific in detecting early stagea
vascular necrosis of the femoral head and can reduce patient’s disability and need for surgery.

Anahtar Kelimeler

COVID-19, Avascular Necrosis, Femoral Head, Osteonecrosis, Case Report

Destekleyen Kurum

None

COVID-19 Enfeksiyonu Sonrası Femur Başının Bilateral Avasküler Nekrozu: Bir Olgu Sunumu

Öz

Amaç: Femur başının avaskuler nekrozu, yetersiz kan akımı neticesinde gelişen, eklem hareket
açıklığında kısıtlanma, ağrı ve yürüme bozukluğu ile karakterize bir tablodur. COVID-19 ve avasküler
nekroz arasındaki ilişkiyi değerlendirmeyi amaçlıyoruz.
Olgu: Burada, COVID-19 sonrası her iki taraf femur başında avaskuler nekroz gelişen 63 yaşında bir
erkek hastayı sunuyoruz.
Sonuç: Tek başına COVID-19 enfeksiyonu veya tedavi etmek için verilen kortikosteroidler, femur
başı avasküler nekroz insidansını artırabilir. Kalça MRG, erken evre femur başı avasküler nekrozunu
saptamada oldukça spesifiktir ve hastanın sakatlığını ve ameliyat ihtiyacını azaltabilir.

Anahtar Kelimeler

COVID-19, Avasküler Nekroz, Femur Başı, Osteonekroz, Vaka Raporu

Kaynakça

• 1. Kordzadeh-Kermani E, Khalili H, Karimzadeh I. Pathogenesis, clinical manifestations and complications of coronavirus disease 2019 (COVID-19). Future Microbiology. 2020;15(13):1287-305. https://doi.org/10.2217/fmb-2020-0110
• 2. Agarwala SR, Vijayvargiya M, Pandey P. Avascular necrosis as a part of ‘long COVID-19’. BMJ Case Reports CP. 2021;14(7):e242101. http://dx.doi.org/10.1136/bcr-2021-242101
• 3. Malizos KN, Karantanas AH, Varitimidis SE, Dailiana ZH, Bargiotas K, Maris T. Osteonecrosis of the femoral head: etiology, imaging and treatment. European journal of radiology. 2007;63(1):16-28. https://doi.org/10.1016/j.ejrad.2007.03.019
• 4. Zalavras CG, Lieberman JR. Osteonecrosis of the femoral head: evaluation and treatment. JAAOS-Journal of the American Academy of Orthopaedic Surgeons. 2014;22(7):455-64. http://dx.doi.org/doi:10.5435/JAAOS-22-07-455
• 5. Assouline-Dayan Y, Chang C, Greenspan A, Shoenfeld Y, Gershwin ME, editors. Pathogenesis and natural history of osteonecrosis. Seminars in arthritis and rheumatism; 2002: Elsevier. https://doi.org/10.1053/sarh.2002.33724b
• 6. Thakur M, Datusalia AK, Kumar A. Use of steroids in COVID-19 patients: A meta-analysis. European Journal of Pharmacology. 2021:174579. https://doi.org/10.1016/j.ejphar.2021.174579
• 7. Chang C, Greenspan A, Gershwin ME. The pathogenesis, diagnosis and clinical manifestations of steroid-induced osteonecrosis. Journal of autoimmunity. 2020;110:102460. https://doi.org/10.1016/j.jaut.2020.102460
• 8. Li W, Huang Z, Tan B, Chen G, Li X, Xiong K, et al. General recommendation for assessment and management on the risk of glucocorticoid-induced osteonecrosis in patients with COVID-19. Journal of orthopaedic translation. 2021;31:1-9. https://doi.org/10.1016/j.jot.2021.09.005
• 9. Mirzai R, Chang C, Greenspan A, Gershwin ME. The pathogenesis of osteonecrosis and the relationships to corticosteroids. Journal of Asthma. 1999;36(1):77-95. https://doi.org/10.3109/02770909909065152
• 10. Daltro G, Franco B, Veiga D, Faleiro T, Lima V, Vitório F. Osteonecrosis Development Post Covid-19 Infection. J Regen Biol Med. 2021;3(5):1-8. https://doi.org/10.37191/Mapsci-2582-385X-3(5)-087
• 11. Disser NP, De Micheli AJ, Schonk MM, Konnaris MA, Piacentini AN, Edon DL, et al. Musculoskeletal consequences of COVID-19. JBJS. 2020;102(14):1197-204. https://doi.org/10.2106/JBJS.20.00847
• 12. Awosanya OD, Dalloul CE, Blosser RJ, Dadwal UC, Carozza M, Boschen K, et al. Osteoclast-mediated bone loss observed in a COVID-19 mouse model. Bone. 2022;154:116227. https://doi.org/10.1016/j.bone.2021.116227
• 13. Daltro G, Silva I, Daltro P, Silva I, Botelho V. SARS-CoV-2/COVID-19 and its implications in the development of osteonecrosis. J Regen Biol Med. 2020;2(4):1-19. https://doi.org/10.37191/Mapsci-2582-385X-2(4)-035