Musculoskeletal
Avascular necrosis (steroid related)
Avascular necrosis is also called osteonecrosis or aseptic necrosis.
- Skeletal complication most often seen in survivors of acute leukemia and lymphoma treated with corticosteroids
- Prevalence varies from 1 - 20 % depending on the series
- Risk depends on quantity of glucocorticoids given
- Associated with delayed intensification therapies for childhood ALL containing dexamethasone
- More common in adolescents than children
- Affects weight bearing joints (most commonly hips and knees)
- Bone "death" occurs
- Clinical spectrum can be mild to severe:
- Asymptomatic spontaneously-resolving imaging changes
- Progressive and painful joint collapse requiring joint replacement
- Symptoms:
- Joint swelling
- Pain
- Reduced mobility
Link:
Avascular necrosis of the femoral head
