MRI screening for osteonecrosis of the femoral head after COVID-19

Kazuma Takashima; Makoto Iwasa; Wataru Ando; Keisuke Uemura; Hidetoshi Hamada; Hirokazu Mae; Yuki Maeda; Nobuhiko Sugano

doi:10.1093/mr/road095

MRI screening for osteonecrosis of the femoral head after COVID-19

Mod Rheumatol. 2023 Oct 7:road095. doi: 10.1093/mr/road095. Online ahead of print.

Authors

Kazuma Takashima¹, Makoto Iwasa², Wataru Ando^{1

3}, Keisuke Uemura¹, Hidetoshi Hamada², Hirokazu Mae¹, Yuki Maeda², Nobuhiko Sugano²

Affiliations

¹ Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
² Department of Orthopaedic Medical Engineering, Osaka University Graduate School of Medicine, Osaka, Japan.
³ Department of Orthopaedic Surgery, Kansai Rosai Hospital, Hyogo, Japan.

PMID: 37804206
DOI: 10.1093/mr/road095

Abstract

Objectives: Systemic steroid administration has been suggested for the treatment of coronavirus disease 2019 (COVID-19), but the occurrence of osteonecrosis of the femoral head (ONFH) was one of the concerns for this treatment. This study aimed to use magnetic resonance imaging (MRI) to assess the incidence of ONFH after treatment COVID-19.

Methods: The study included 41 patients who were hospitalized and treated for pneumonia or other COVID-19-induced diseases. We conducted interviews with these patients regarding hip pain and performed MRI screenings for ONFH. The incidence and timing of ONFH after COVID-19 treatment were investigated.

Results: Of the 41 patients, one died of pneumonia, and the remaining patients did not complain of hip pain. MRI screening of 26 patients was performed, and asymptomatic ONFH was detected in one patient (3.8%) whose ONFH appeared 1 month after the COVID-19 infection.

Conclusion: Our MRI screening of ONFH in post-COVID-19 patients revealed asymptomatic ONFH, which would not have been identified without active screening. Physicians should be aware that ONFH may occur in patients after treating COVID-19.

Keywords: coronavirus disease 2019; magnetic resonance imaging; osteonecrosis of the femoral head; screening examination; steroid.