Hip Pelvis.  2019 Jun;31(2):120-123. 10.5371/hp.2019.31.2.120.

Bilateral Avascular Necrosis of the Femoral Head in a Patient with Asymptomatic Adrenal Incidentaloma

• Ha JS
• Cho HM
• Lee HJ
• Kim SD

• KMID: 2448031
• DOI: http://doi.org/10.5371/hp.2019.31.2.120

Abstract

Except when caused by direct and definite mechanisms (e.g., injury of the vessels to the femoral head), the pathophysiology of avascular necrosis of the femoral head has not yet been fully elucidate. While non-traumatic avascular necrosis of the femoral head is known to be caused by alcohol, steroids and various diseases, it may also occur without such events in a patient's history. Herein, a case of bilateral avascular necrosis of the femoral head caused by asymptomatic adrenal cortex incidentaloma which was initially misdiagnosed as idiopathic is reported along with a literature review.

Keyword

Adrenal gland neoplasms; Cushing's syndrome; Femur head necrosis

MeSH Terms

Adrenal Cortex
Adrenal Gland Neoplasms
Cushing Syndrome
Femur Head Necrosis
Head*
Humans
Necrosis*
Steroids
Steroids

Figure

• 

  Fig. 1 Femoral head necrosis in a 36-year-old female patient. (A) Anteroposterior view of the right femoral head reveals areas of hyperlucency and surrounding sclerosis, as well as subtle changes in the shape of the articular surface. (B) Magnetic resonance imaging of the hip joint. Bilateral femoral head osteonecrosis, noted to be more extensive in the left hip. (C) Radiograph 12 months after initial examination reveals severe joint destruction of the right femoral head (D) and following total hip arthroplasty.

• 

  Fig. 2 (A) A homogeneous mass with a smooth border, prompt washout and an attenuation value of less than 10 Hounsfield units on unenhanced computed tomography. (B) Gross photograph of the cut surface of the adrenal gland. The tumor, which is 2.0 cm in diameter, is composed of interspersed yellow and brown areas.

Reference

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