Multiple bone osteonecrosis following corticosteroid use

Introduction: Osteonecrosis is a disease that causes pain due to an interruption in the blood supply. It is more common in women, and some factors such as trauma, corticosteroid use, sickle cell anemia, lupus and rheumatoid arthritis can increase the risk of the disease. Imaging tests are used for diagnosis: X-rays and magnetic resonance imaging. Treatment can be clinical or surgical, as in this case. Objectives: To report a case of osteonecrosis in a young patient, the diagnostic screening and the outcome after treatment. Methodology: This is a descriptive observational study based on the analysis of the patient's medical record and literature review. Results: A 30-year-old woman came for a consultation due to knee pain with swelling one year ago. She reported an episode of herpes zoster requiring corticosteroids, and hip pain after the appearance of knee lesions. X-rays of the femur and knee and magnetic resonance imaging were carried out and the diagnosis was femoral osteonecrosis (Ficat Arlet type 2) and osteonecrosis of the left knee. Femoral-acetabular decompression and arthroscopy for knee biopsy were performed. Knee biopsy showed bone tissue with an area of fibrosis, fragments of adipose tissue and recent hemorrhage and synovial tissue. The patient improved clinically after decompression. Conclusion: This is a case of a surgical approach to improve the clinical condition of a young patient with osteonecrosis, who improved significantly after surgical decompression.