A vascular necrosis of metacarpal heads following renal transplantation

Abstract

Avascular necrosis of bone, especially that of the femoral head, is a well-known complication of long term systemic steroid therapy in renal transplant recipients (Jacobs, 1978). This report is of a patient with wide-spread disease affecting, in addition to most major joints, the heads of metacarpal bones. This 23-year-old Hindu female has been receiving cytotoxic and steroid therapy since she had her renal graft in March 1976. The original daily dose of steroids was 30 mg of prednisolone reduced gradually to 15 mg by December 1976. In addition, she received a total dose of 3.5 g of methyl prednisone during the first six months for rejection episodes. In September 1976 she complained of pains in her hips and knees. The radiographs obtained at that time showed typical appearances of avascular necrosis at both femoral heads and both knees.