Avascular Necrosis of the Femoral and Humeral Heads after High-Dosage Corticosteroid Therapy

Abstract

THE medical literature of the past ten years contains many reports of injurious side effects of systemic corticosteroid therapy.1 2 3 4 Osteoporosis and resulting vertebral fractures are almost the only skeletal changes caused by long-term corticosteroid therapy.5 Pietrograndi and Mastromarino6 described a single case of joint destruction after prolonged oral cortisone therapy. Sweetnam7 describes a case of unusually rapid and severe hip-joint arthropathy in a man who received oral and intra-articular administration of corticosteroids for rheumatic arthritis. The actual changes are described as "Charcot-like" in character and genesis. The damaging effects of intraarticular injections of cortisone have been amply described by Chandler . . .