Multifocal osteonecrosis glucocorticoid induced

Abstract

The present study describes a 29 years old patient diagnosed with aseptic osteonecrosis with multiple localization occurred after a corticoid treatment for chronic toxic hepatitis. The clinical and paraclinical examinations determined the diagnosis of Wilson disease and avascular necrosis with multiple localizations. The evolution of the disease was favourable following the surgical treatment consisting of bilateral total hip arthroplasty with cementless prosthesis, hemiarthroplasty of the left shoulder with cementless prosthesis, orthotopic hepatic transplantation with an entire liver from donor in cerebral death and immunosuppressive, anticoagulant, antiretroviral and gastroprotective treatment. There is an increase of the number of patients undergoing a glucocorticoids treatment for several months, years or lifelong periods. This type of treatment increases the risk of osteonecrosis depending on the dosage and the duration of the treatment.