Case Report

Co-occurrence of subchondral insufficiency fracture of the femoral head and contralateral femoral neck fracture in a rheumatic patient receiving steroid treatment

Authors

Keita Miyanishi¹, Toshihiko Hara¹, Tetsuo Hamada², Masayuki Maekawa³, Susumu Tsurusaki¹, Taka-aki Moro-oka¹, Yoshi Kamo¹, Seiya Jingushi¹ and Takehiko Torisu¹

1. Department of Orthopaedic Surgery, Kyushu Rosai Hospital, 1-3-1 Kuzuharatakamatsu, Kokuraminami-ku, Kitakyushu 800-0296, Japan
2. Department of Pathology, Kyushu Rosai Hospital, Kitakyushu, Japan
3. Maekawa Rheumatology and Orthopaedic Clinic, Kitakyushu, Japan

Received:

14 April 2008

Accepted:

11 May 2008

Published online:

27 June 2008

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Abstract

We describe a 79-year-old woman with rheumatoid arthritis who suffered from subchondral insufficiency fracture of the femoral head (SIF) and contralateral femoral neck fracture. Radiographs obtained two months after the onset of thigh pain showed collapse of the right femoral head and contralateral femoral neck fracture. MRI revealed a subchondral serpiginous low-intensity band in the right femoral head on the T2-weighted image. This case report suggests that SIF should be considered in the differential diagnoses of rheumatic patients who suffer from thigh pain without antecedent trauma.

Key words

Hip joint - MRI - Rheumatoid arthritis - Subchondral insufficiency fracture