The aim of this study was to describe X-ray and computed tomography signs and to estimate the severity of femoral head necrosis in patients with sickle cell disease. We studied two groups of patients with sickle cell disease (group A: 14 patients with no hip pain and group B: 34 patients with hip pain) over 17 months. Each patient underwent hip X-ray (lying face-down) and CT scan. None of the patients in group A presented hip lesions whereas we detected 42 necrotic femoral head lesions by standard X ray and 51 by CT scan. The lesions were frequently bilateral (82.14%) and were more frequent in young patients (from 11 to 30 years old). Their progression was faster in patients with the SS genotype. No significant difference was observed according to type of hemoglobin. All patients with sickle cell disease presenting with hip pain should undergo CT scan to check for femoral head necrosis.
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