High Prevalence of Osteonecrosis of the Femoral Head in HIV-Infected Adults

  1. Kirk D. Miller, MD;
  2. Henry Masur, MD;
  3. Elizabeth C. Jones, MD, MPH;
  4. Galen O. Joe, MD;
  5. Margaret E. Rick, MD;
  6. Grace G. Kelly, MSS;
  7. JoAnn M. Mican, MD;
  8. Shuying Liu, BSN;
  9. Lynn H. Gerber, MD;
  10. William C. Blackwelder, PhD;
  11. Judith Falloon, MD;
  12. Richard T. Davey, Jr., MD;
  13. Michael A. Polis, MD, MPH;
  14. Robert E. Walker, MD;
  15. H. Clifford Lane, MD; and
  16. Joseph A. Kovacs, MD
  1. From the Clinical Center and National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland.
    1. Figure 1.
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      Figure 1. Magnetic resonance imaging scans of three patients with lesions of osteonecrosis (arrows).

      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.

    2. Figure 2.
      View larger version:
      Figure 2. Magnetic resonance imaging scans of three patients with unilateral lesions of osteonecrosis (arrows).

      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.

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    1. Ann Intern Med July 2, 2002 vol. 137 no. 1 17-25
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