Spontaneous bone infarction of the distal femur in a patient with Cushing's disease: a case report

Pepijn van Houten; Jacky de Rooy; Ingrid van der Geest; Romana Netea-Maier; Annenienke van de Ven

doi:10.1016/j.bonr.2021.100756

Spontaneous bone infarction of the distal femur in a patient with Cushing's disease: a case report

Bone Rep. 2021 Feb 18:14:100756. doi: 10.1016/j.bonr.2021.100756. eCollection 2021 Jun.

Authors

Pepijn van Houten¹, Jacky de Rooy², Ingrid van der Geest³, Romana Netea-Maier¹, Annenienke van de Ven¹

Affiliations

¹ Department of Internal Medicine, Division of Endocrinology, Radboud University Medical Centre, Nijmegen, the Netherlands.
² Department of Radiology and Nuclear Medicine, Radboud University Medical Centre, Nijmegen, the Netherlands.
³ Department of Orthopedic Oncologic Surgery, Radboud University Medical Centre, Nijmegen, the Netherlands.

Abstract

Avascular necrosis of the femoral head is a well-known complication of treatment with high dosage glucocorticoids and has been described in a few patients with Cushing's syndrome. In this case report, we describe the, to our knowledge, first case of a patient with endogenous Cushing's syndrome with a bone infarction located in the distal femur. In patients with Cushing's syndrome and bone pain, the diagnosis of bone infarction should be considered as it can occur as a rare complication of hypercortisolism.

Keywords: ACTH, adrenocorticotropic hormone; ALL, acute lymphoblastic leukemia; AVN, avascular necrosis; Avascular necrosis; Bone infarction; CS, Cushing's syndrome; Cushing's disease; DST, 1 mg dexamethasone suppression test; LMWH, low-molecular weight heparin; MRI, magnetic resonance imaging; Osteonecrosis; n, normal value.

Publication types

Case Reports