Concomitant early avascular necrosis of the femoral head and acute bacterial arthritis by enteric Gram-negative bacilli in four oncologic patients

Tan TJ, Tan SC
Correspondence: Dr Tan Tien Jin, tien_jin_tan@cgh.com.sg

ABSTRACT
We present four cases of concomitant early (modified Ficat-Arlet stage I) avascular necrosis of the femoral head and acute bacterial arthritis of the hip joint by Gram-negative enteric bacilli. This was found in immunosuppressed oncologic patients whose clinical presentations and radiological findings were not entirely specific for joint sepsis. It is important to recognise the coexistence of these two pathologies, so as to avoid a delay in diagnosis and prevent significant morbidity and mortality.

Keywords: avascular necrosis, hip, magnetic resonance imaging, oncology, septic arthritis
Singapore Med J 2013; 54(5): e108-e112; http://dx.doi.org/10.11622/smedj.2013065

http://smj.org.sg/sites/default/files/5405/5405cr5.pdf

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