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Year : 2023  |  Volume : 11  |  Issue : 1  |  Page : 98-101

Avascular necrosis of hip joints in post-COVID-19 patients: A case series

1 Department of Radiodiagnosis, Malla Reddy Institute of Medical Sciences, Hyderabad, Telangana, India
2 Department of Radiodiagnosis, Malla Reddy Medical College for Women, Hyderabad, Telangana, India

Correspondence Address:
Santosh Karpur
Department of Radiodiagnosis, Malla Reddy Institute of Medical Sciences, Hyderabad, Telangana
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/mjhs.mjhs_97_22

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Risk of bone necrosis is increased in patients with COVID-19 due to hypercoagulability. The hypercoagulability is caused by gene encoding for pro-inflammatory proteins which is due to single nucleotide polymorphism. All these mechanisms namely aggregation of leukocytes, hypercoagulability, and inflammation of the vessels can lead to reduced blood supply to the bone. This can ultimately lead to necrosis of the bone. The present case series of 20 cases attempts to study the avascular necrosis (AVN) of hip joint in patients with COVID-19. A history related to AVN was recorded. The patient was screened with plain radiographs of the affected joint. Magnetic resonance imaging (MRI) examination of Hip joint was done on the same day as plain radiograph. The Modified Ficat classification system for MRI was used for staging AVN of the femoral head. The mean interval between the onset of initial symptoms and MRI was 2–4 weeks. Majority of the patients were diagnosed as Stage I (45%). Males were affected more than females, i.e., 70% versus 30%. Fever and hip pain were the most common presenting symptoms. We conclude from the present case series that COVID-19 may be associated with AVN of hip joint as all post-COVID cases had AVN. Hence, all patients who recovered from COVID-19 should be screened for AVN for early diagnosis and prompt treatment.

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