Acetabular avascular necrosis following high-dose steroid treatment and chemotherapy for leukemia

We present a case of a 20-year-old man with ALL who was diagnosed with debilitating AVN of both acetabula 2  years following initial diagnosis of ALL and treatment with a multi-agent chemotherapy regimen including high-dose corticosteroids. After unsuccessful treatment with bisphosphonate therapy, the acetabular AVN underwent bilateral curettage and impaction bone grafting to prevent collapse of subchond ral fractures with the hope of salvaging both hip joints. Computer tomography (CT) of the AVN affected areas, pre- and post-bone impaction grafting, demonstrated healing of the subchondral fractures and a doubling of bone density that was maintained at 2 years after surgery. The patient resumed ful l weight-bearing at 3 months after first surgery, continues to ambulate unrestricted, and remains pain free 3 years post-surgery.
Source: Skeletal Radiology - Category: Radiology Source Type: research