Avascular necrosis of the femoral head in sickle cell disease patients.

Background: Avascular necrosis of the femoral head (ANFH) has been described as a frequent outcome in patients with sickle cell disease (SCD). The objective of the current report is to present the prevalence of ANFH in patients under the age of 21 suffering from SCD as well as discuss some possible associated risk factors.

Material And Method: A cross-sectional study was carried out in a group of 100 patients. Clinical, demographic variables and risk factors were investigated. Seventy-two patients had their data completely analyzed. Eight patients were found to be affected and comprise the study group while the other 64 patients comprised the comparison group.

Results: The prevalence of ANFH was 8 out of 72 (11.1%). Age (p=0.042), weight (p=0.04) and hemoglobin levels (0.048) were associated with ANFH. Correlations with time from diagnosis (p=0.14), ulcers (p=0.013), ferritin levels (p=0.07) and a family history of thrombosis were near-significant.

Conclusions: The attention of physicians treating SCD patients must also be drawn to the possibility of ANFH in order to prevent or avoid this disastrous complication, especially in younger patients presenting with frequent hemolytic crises.