Kirk D. Miller, MD; Henry Masur, MD; Elizabeth C. Jones, MD, MPH; Galen O. Joe, MD; Margaret E. Rick, MD; Grace G. Kelly, MSS; JoAnn M. Mican, MD; Shuying Liu, BSN; Lynn H. Gerber, MD; William C. Blackwelder, PhD; Judith Falloon, MD; Richard T. Davey, MD; Michael A. Polis, MD, MPH; Robert E. Walker, MD; H. Clifford Lane, MD; Joseph A. Kovacs, MD
Miller KD, Masur H, Jones EC, Joe GO, Rick ME, Kelly GG, et al. High Prevalence of Osteonecrosis of the Femoral Head in HIV-Infected Adults. Ann Intern Med. 2002;137:17-25. doi: 10.7326/0003-4819-137-1-200207020-00008
Download citation file:
Published: Ann Intern Med. 2002;137(1):17-25.
Osteonecrosis (avascular necrosis) of the hip is an uncommon but painful and disabling condition that sometimes requires total hip replacement.
This large survey showed that an unusually high percentage of HIV-infected adults (4.4% [95% CI, 2.5% to 7.2%]) had osteonecrosis of the hip, as detected by magnetic resonance imaging.
Although screening asymptomatic HIV-infected patients is not warranted, osteonecrosis should be considered in HIV-infected patients with persistent groin or hip pain.
Shown are screening coronal T1-weighted images (left) and corresponding fat-suppressed T2-weighted images (right). A. Unilateral osteonecrosis in one patient. B and C. Bilateral osteonecrosis in two patients. In addition to having the curvilinear lesions of osteonecrosis, the patient at bottom (panel C) has increased signal in the head and neck of the left femur, consistent with edema surrounding the area of osteonecrosis. The patients in panels B and C developed symptoms after study enrollment.
Shown are high-resolution T1-weighted images (left) and corresponding fat-suppressed T2-weighted images (right). A. Coronal view of a wedge-shaped lesion of the anteromedial femoral head. B. Saggital view of a small subchondral lesion of the anterior superior aspect of the femoral head. C. Axial view of a large curvilinear lesion of the femoral head.
The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.
HIV, Infectious Disease.
Results provided by:
Copyright © 2017 American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704
Conditions of Use
This PDF is available to Subscribers Only