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KMID : 0948920080070010032
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Clinical Pain
2008 Volume.7 No. 1 p.32 ~ p.36
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Nontraumatic Osteonecrosis of Bilateral Femoral Heads and Humeral Heads -Case Report-
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Kim Chul
Ahn Jae-Ki
Park Yong-Bum
Yoon Jo-Eun
Kim Duk-You
Lee Dong-Woo
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Abstract
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Osteonecrosis is defined as the death of bone marrow and trabecular bone due to the disruption of blood supply to the bone. Most occurrences are secondary to trauma, but may also result from glucocorticoid therapy, radiation therapy, alcoholism, smoking, connective tissue diseases, hematologic or metabolic disorders. We presented a case of a male patient with avascular necrosis of bilateral femoral heads and humeral heads without trauma, systemic glucocorticod administration, or other risk factors other than smoking. A 75-year-old man was initially presented to emergency department with complaints of severe shoulder pain, bilaterally. He underwent total hip replacement surgeries in the right side 15 years ago and in the left side 10 years ago due to avascular necrosis. There was no history of preceding trauma or systemic glucocorticoid administration. Notable findings from his social history included a 40 pack a year smoking habit and moderate alcohol intake for 50 years. He was diagnosed with avascular necrosis of bilateral humeral heads based on clinical and radiologic findings. Any evidence of coagulopathy, connective tissue diseases, or septic arthritis was not found during further evaluation. We recommended bilateral shoulder replacement surgery, but the patient refused it and took conservative treatment. He reported reduced pain and improved function after treatment.
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KEYWORD
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Nontraumatic osteonerosis, Humeral heads, Alcohol
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