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Case Reports
. 2024 Dec;53(12):2741-2744.
doi: 10.1007/s00256-024-04673-9. Epub 2024 Apr 8.

Corticosteroid-associated osteonecrosis of the femoral head in an 87-year-old patient following treatment for COVID-19-associated pneumonia: A case report

Fumihiro Yoshimura  1 , Kenichiro Doi  1 , Koichi Kinoshita  1 , Hajime Seo  1 , Taiki Matsunaga  1 , Takuaki Yamamoto  2
Affiliations
Case Reports

Corticosteroid-associated osteonecrosis of the femoral head in an 87-year-old patient following treatment for COVID-19-associated pneumonia: A case report

Fumihiro Yoshimura et al. Skeletal Radiol. 2024 Dec.

Abstract

Coronavirus disease 2019 is known to cause severe acute respiratory syndrome, and serious cases need to be treated with corticosteroids. Herein, we report an 87-year-old woman who developed bilateral osteonecrosis of the femoral head after corticosteroid treatment for coronavirus disease 2019-related pneumonia. Sixteen months after treatment, she developed right hip pain without any evidence of trauma. A diagnosis of bilateral osteonecrosis of the femoral head was made based on sclerotic bands on plain radiographs and low-signal bands on T1-weighted magnetic resonance images. The patient underwent right total hip arthroplasty 4 months after symptom onset. Histological examination of the resected femoral head revealed pathological evidence of osteonecrosis. The postoperative course was good, and the patient can now walk unassisted. To the best of our knowledge, this is the first report of histologically proven osteonecrosis after corticosteroid therapy for coronavirus disease 2019-related disease.

Keywords: COVID-19-associated pneumonia; Corticosteroid; Histology; Osteonecrosis of the femoral head.

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