Avascular necrosis of bone following systemic steroid therapy.

Abstract

Avascular necrosis of bone and resultant joint destruction are uncommon and generally unrecognized complications of systemic corticosteroid therapy (1, 3, 7, 12, 14). Few examples with no associated bone or joint disease have been reported in the literature (1, 2, 13). Recently, however, such a case was seen at The Christ Hospital (Cincinnati, Ohio). Case Report Mrs. E. M., a 50-year-old white woman, had a subtotal thyroidectomy in 1929, a pelvic laparotomy for adhesions in 1934, a right salpingo-oophorectomy and appendectomy for tubal pregnancy in 1938, and a total colectomy with an ileostomy in 1945, for what was diagnosed elsewhere as an “elongated, atrophic, atonic colon.” She had been taking desiccated thyroid daily since 1934. In 1955, she noticed the occurrence of easy bruising after only slight trauma and occasional bloody drainage from the ileostomy. Some increase in capillary fragility was demonstrated, but there was no thrombocytopenia. Then, in 1957, there was a recurrent episode of purpura wi...