Femoral head avascular necrosis during pregnancy: a case report

Abstract

Introduction/Background Osteonecrosis is caused by impaired blood supply to the affected bone. It results with destruction of bone structure, which leads to joint pain and loss of function. There are very few published cases about pregnancy as single etiological factor for femoral head osteonecrosis in healthy women. Material and Method A healthy 26-year-old at the 32nd weeks of pregnancy presented with suddenly developed sharp, constant pain (VAS 5-7) in the right hip area. Pain decreased in two weeks, after physiotherapy in a vertical bath and water trail. However, due to eczema, hydrotherapy was discontinued. Pain reoccurred and was evaluated up to 6-8 VAS points. After delivery at 41st week of gestation, the pain intensified (VAS 10 points), the patient was unable to walk. MRI indicated the right hip osteonecrosis. Patient was treated by allowing walking with crutches without stepping on the right foot for at least 2 months, NSAIDs (colecoxib 100mg 1/d), calcium, passive physiotherapy, TENS, MT, EF with calcium chloride, HILT therapy, hip joint massage. Results After 2 months of rest, patient started to actively use the right foot, using 50% of body weight, increasing to 100% within 4 weeks. After inpatient rehabilitation she began to fully step on the right foot, pain decreased, range of motion of both hip joints became equal, right thigh and gluteal muscles strengthened. [...].