Multifocal osteonecrosis in a patient with anamnestic ulcerative colitis. Is there a relationship with the disease and the use of glucocorticoids twenty years before? A brief review of the literature

What Researchers Did

Researchers presented a case report about a 40-year-old man who developed multifocal osteonecrosis in his shoulders and hips after a history of ulcerative colitis and glucocorticoid use.

What They Found

The patient was diagnosed with stage III and IV osteonecrosis and received a cycle of hyperbaric oxygen therapy, two cycles of intravenous clodronate, and a two-month cycle of teriparatide. This combined treatment was able to save sufficient function for both shoulders, but both hips ultimately required arthroplasty surgery.

What This Means for Canadian Patients

This case suggests that patients with a history of ulcerative colitis and glucocorticoid use may be at risk for developing multifocal osteonecrosis. While hyperbaric oxygen therapy, alongside other treatments, may help preserve function in some affected joints, severe cases might still necessitate surgical intervention. Patients experiencing joint pain with similar medical histories should discuss potential osteonecrosis with their healthcare provider.

Canadian Relevance

No direct Canadian connection identified.

Study Limitations

As a single case report, these findings cannot be generalized to all patients with osteonecrosis or similar medical histories.