Steroid Tedavisine Sekonder Gelişen Bilateral Femur Ve Tibiada Yaygın Osteonekroz Pediatrik Olgu

Öz

Yüksek doz ve uzun süreli sterid kullanımı osteonekroza yol açabilir. Manyetik rezonans görünütleme, tipik bulguları ile, osteonekrozu saptamada en iyi tanı yöntemidir. Bu yazıda 2 yıldır nefrotik sendrom tanısıyla steroid tedavisi görmüş, bilateral diz ağrısı şikayetiyle başvuran 16 yaşındaki erkek hastanın manyetik rezonans incelemesinde bilateral femur ve tibiada izlenen osteonekroz lezyonlarınının tipik bulguları sunulmuştur. Dr. Mehmet Sait DOGAN Dr. Sümeyra DOĞAN Dr. Selim DOĞANAY Dr. Gonca KOÇ Dr. İsmail DURSUN Dr. Abdulhakim COŞKUN

Anahtar Kelimeler

• Manyetik rezonans görüntüleme
• steroid
• osteonekroz
• kemik infarktı
• çift çizgi bulgusu.

Steroid-Induced Extensive Bilateral Femoral And Tibial Osteonecrosis:A Pediatric Case

Öz

High dose or prolonged use of steroids may lead to osteonecrosis. Magnetic resonance imaging is the best diagnostic tool with typical findings to detect osteonecrosis in the early stages. We herein report a 16-year-old male patient who suffered from bilateral knee pain with a history of nephrotic syndrome for 2 years, treated with multiple courses of steroids and discuss typical magnetic resonance findings of bilateral multiple osteonecrosis lesions in both femurs and tibias.

Anahtar Kelimeler

• Magnetic resonance imaging
• steroids
• osteonecrosis
• bone infarct
• double line sign

Kaynakça

1. 1. Saini A, Saifuddin A. MRI of Osteonecrosis. Clinical Radiology 2004;59: 1079-93.
2. 2. Mirzai R, Chang C, Greenspan A,Gershwin ME. The Pathogenesis of Osteonecrosis and the Relationships to Corticosteroids. Journal of Asthma 1999; 36:77-95.
3. 3. Zurlo JV. The Double-Line Sign. Radiology 1999;212:541-2.
4. 4. Brooker BJ, Keith PPA. Osteonecrosis: The perils of steroids. A review of the literature and case report. Case Reports in Clinical Medicine 2012;1:25-36.
5. 5. Gladman DD, Chaudhry-Ahluwalia V, Ibanez D, Bogoch E, Urowitz MB. Outcome of symptomatic osteonecrosis in 95 patients with systemic lupus erythematosus. J Rheumatol 2001;28:2226-9.
6. 6. Sansgiri RK, Neel MD, Soto-Fourier M, Kaste SC. Unique MRI Findings as an Early Predictor of Osteonecrosis in Pediatric Acute Lymphoblastic Leukemia. AJR2012;198:W432-W9.
7. 7. Karimova EJ, Rai SN, Ingle D, et al. MRI of knee osteonecrosis in children with leukemia and lymphoma: Part 2, clinical and imaging patterns. AJR Am J Roentgenol 2006;186:477-82.