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Correspondence
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Volume 330:791-792 March 17, 1994 Number 11
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Osteonecrosis of the Femoral Heads in Inflammatory Bowel Disease

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by Freeman, H. J.
To the Editor: The Brief Report by Freeman and Kwan (Oct. 28 issue)1 describes presumed osteonecrosis in two patients with inflammatory bowel disease who had not received glucocorticoid therapy. We believe that the radiographic diagnosis is in error. In both patients, the radiographs show uniform diffuse narrowing of the joint space in both hips, with maintenance of the normal contour of the femoral heads in the early radiographs. This pattern is consistent with an inflammatory arthropathy and is not consistent with osteonecrosis as the primary disease. Osteonecrosis is a primary bone problem (infarction) that results in radiographic sclerosis and lucency . . . [Full Text of this Article]

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