Late Metachronous Involvement of the Contralateral Hip in Legg-Calvé-Perthes Disease

Avascular necrosis of the femoral head following heart transplant in a child

“…Steroid use is an accepted cause of avascular necrosis of the femoral head and has been reported to be a risk factor in 45% of affected patients (8, 9) There appears to be no minimum or threshold dose, but it has been suggested that pulsed parenteral steroids as were used in this patient may be an etiologic factor (4). Avascular necrosis associated with steroid use is usually bilateral although it may manifest only on MRI, and usually but not always occurs within 2 yr of steroid use.…”

“…The underlying disease also has prognostic impact. Patients with leukemia have better results than those with chronic autoimmune disease (8).…”