Abstract
Background: Avascular necrosis of the head of the femur (AVNF) is commonly reported in certain types of hemoglobinopathies, such as sickle cell disease. However, very few cases of AVNF have been reported with transfusion-dependent beta-thalassemia (TDT). Case Presentation: This paper reports a case of a 13-year-old boy known case of TDT who was on regular blood transfusion and iron chelation therapy and who presented with left hip pain associated with movement limitation for 1 month. Musculoskeletal examination revealed tenderness along the joint line of the left hip and decreased range of motion in this hip. Plain X-ray revealed atrophy of the left femoral head. The diagnosis was confirmed with magnetic resonance imaging, which showed left femoral head necrosis. The patient was treated initially with bed rest and analgesia and later by surgery. Conclusion: Many bone complications are associated with TDT such as bone deformity and osteoporosis, but AVNF is a very rare complication and has multifactorial etiology. Physicians are encouraged to consider the possible presentation of AVNF in TDT patients, mainly if they present with hip pain.
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