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Corticosteroid-Induced Avascular Necrosis A CLINICAL STUDY OF SEVENTY-SEVEN PATIENTS
DARRELL E. FISHER; WILLIAM H. BICKEL
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From the Mayo Graduate School of Medicine (University of Minnesota) and the Department of Orthopedics, Mayo Clinic and Mayo Foundation, Rochester, Minnesota
1971 by The Journal of Bone and Joint Surgery, Incorporated
The Journal of Bone & Joint Surgery.  1971; 53:859-873 
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Abstract

A complete review was made of seventy-seven cases of non-traumatic avascular necrosis of bone in patients treated with corticosteroids seen at the Mayo Clinic from 1950 to 1968. The single common finding was treatment with corticosteroids in dosages greater than physiological replacement for long periods either continuously or intermittently. Serum lipids were abnormal in the majority of cases so studied. Roentgenograms showed characteristic segmental avascular necrosis followed by varying degrees of collapse and secondary degenerative changes. Gross and histological study of surgically removed femoral heads confirmed the diagnosis of avascular necrosis. Intravascular fat emboli were noted in a significant number of femoral heads removed from corticosteroid-treated patients with avascular necrosis.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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