JORR
Journal of Orthopedics Research and Rehabilitation

The Journal of Orthopedics Research and Rehabilitation welcomes scholarly papers inorthopaedic surgery, physical therapy and rehabilitation, neurosurgery, neurology and clinic anesthesiology and reanimation.

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Case Report
Short period corticosteroid therapy related multifocal ostonecrosis: a case report
Abstract
Corticosteroid therapy is the most common iatrogenic etiologic factor for osteonecrosis and is most commonly seen in the femoral head. When osteonecrosis occurs in 3 or more regions, it is called multifocal osteonecrosis. The fact that corticosteriod treatment was administered in very large groups of patients during the coronavirus (COVID-19) pandemic indicates that large groups of patients with osteonecrosis will be encountered in a certain period. Despite the large patient masses treated with corticosteriod, the low number of reported cases of multifocal osteonecrosis suggests that it may be clinically asymptomatic. The paucity of studies reporting multifocal osteonecrosis despite extensive corticosteroid use suggests that it may be asymptomatic. The aim of this article is to present a case of multifocal osteonecrosis after short-term low dose corticosteroid use and to describe its clinical features. There is a variable relationship between the risk of osteonecrosis and steroid use. Multifocal osteonecrosis is a treatment complication that can develop even after short-term low-dose corticosteroid use. The widespread use of corticosteroids during the COVID-19 pandemic appears to be a risk factor for increased incidence of osteonecrosis.

Keywords : Multifocalosteonecrosis, COVID-19, facial paralysis, glucocorticoid

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1. Pavelka K. Osteonecrosis. Best Prac Res Clin Rheum, 2000;14(2):399-414.
2. Chan KL, Mok CC. Glucocorticoid-induced avascular bone necrosis:diagnosis and management. Open Orthop J. 2012;6(1):449-450.
3. Krez A, Lane J, Heilbronner A, et al. Risk factors for multi-joint diseasein patients with glucocorticoid-induced osteonecrosis. Osteoporos Int.2021;32(1):2095-2103.
4. Chang C, Greenspan A, Gershwin ME. The pathogenesis, diagnosis andclinical manifestations of steroid-induced osteonecrosis. J Autoimmun.2020;110(3):102460.
5. Group CO. Symptomatic multifocal osteonecrosis. A multicenter study.Clin Orthop Relat Res. 1999;369(3):312-326.
6. Sun W, Shi Z, Gao F, Wang B, Li Z. The pathogenesis of multifocalosteonecrosis. Scient Rep. 2016;6(1):1-6.
7. Zhan Y, Shang J, Gu Y, Huang Q, Xie J. Efficacy of corticosteroid inpatients with COVID-19: a multi-center retrospective study and meta-analysis. J Med Virol. 2021;93(7):4292-4302.
8. Mercado JSC, Lievano JR, Zaldivar B, Barajas C, Fierro G, GonzálezJC. Atraumatic osteonecrosis of the humeral head: pathophysiologyand current concepts of evaluation and treatment. JSES Rev Rep Tech.2022;2(3):277-284.
9. Sultan AA, Mohamed N, Samuel LT, et al. Classification systems of hiposteonecrosis: an updated review. Int Orthop. 2019;43(1):1089-1095.
10. Koo KH, Kim R, Kim YS, et al. Risk period for developing osteonecrosisof the femoral head in patients on steroid treatment. Clin Rheuma.2002;1(1):299-303.
11. Mont MA, Pivec R, Banerjee S, Issa K, Elmallah RK, Jones LC. High-dose corticosteroid use and risk of hip osteonecrosis: meta-analysis andsystematic literature review. J Arthroplasty. 2015;30(9):1506-1512.
12. Dilisio MF. Osteonecrosis following short-term, low-dose oralcorticosteroids: a population-based study of 24 million patients.Orthop. 2014;37(7):631-639.
13. Veizi E, Erdoğan Y, Sezgin BS, Karaman Y, Kılıçarslan K, Fırat A. Thepainful joint after COVID-19 treatment: a study on joint osteonecrosisfollowing COVID-19-related corticosteroid use. Joint Dis Rel Surg.2023;34(1):75.
14. Wang Y, Jiang W, He Q, et al. A retrospective cohort study ofmethylprednisolone therapy in severe patients with COVID-19pneumonia. Signal Transduct Targeted Therapy. 2020;5(1):57.
15. Recovery collaborative group. Dexamethasone in hospitalized patientswith Covid-19. NEJM. 2021;384(8):693-704.
16. Shetty GM. Double trouble-COVID-19 and the widespread use ofcorticosteroids: are we staring at an osteonecrosis epidemic? Indian JOrthop. 2021;56(2):1-11.
Article available in :
Volume 1, Issue 4, 2023
Page : 89-91
https://doi.org/10.51271/JORR-0020
Article Information
Received : 01 Eki 2023
Accepted : 27 Eki 2023
Published : 30 Eki 2023
Corresponding Author :

Furkan Soy: Kahramankazan State Hospital

[email protected]
Citation : Soy F, Çırpar M. Short period corticosteroid therapy related multifocal ostonecrosis: a case report. J Orthop Res Rehabil. 2023;1(4):89-91.

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