Avascular necrosis of the humeral head associated with idiopathic avascular necrosis of the hip.

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The shoulder X-ray films in ninety-eight patients with idiopathic avascular necrosis (AVN) of the femoral head were taken to determine the incidence of AVN of the shoulder in AVN of the hip. In addition, the roentgenographic findings of AVN of the humeral head were studied. Ten patients-10.2% of 98 patients- who revealed the shoulder lesion were deviled into the following causes: two of 38 patients associated with alcoholism (5.3%); six of thirty-five corticosteroid-treated patients (17.1%); two of twenty-five patients without any causes (8%). The incidence of the shoulder lesion in steroid-treated patients was two to three times higher than that in other causes. Six steroid-treated patients were suffering from the following diseases: two of 14 SLE patients (14.3%); three of eleven patients with nephrotic syndrome (27.1%); one patients with aortitis syndrome. As an initial roentgenographic change, subchondral translucent line, band-like areas of sclerosis, and radiolucent area around the anatomical neck of the humerus were found in the steroid-induced group. The site of area of the collapse was first seen at the supero-medial portion of the humeral head. Severe incongruity of the joint surface would be reduced to osteoarthritis in the late stage.
西日本整形・災害外科学会の論文