An unusual case of metaphyseal osteonecrosis of humerus in a post covid patient: a case report

Pan Afr Med J. 2022 Jul 29:42:244. doi: 10.11604/pamj.2022.42.244.34337. eCollection 2022.

Abstract

Osteonecrosis of the metaphysis is often rare as it is a highly vascular region. Here we report an unusual case of non-traumatic osteonecrosis of the humerus predominantly involving the metaphysis in a post covid elderly female. The patient had a pathological fracture of humerus during the post-operative period of intertrochanteric femur fracture surgery. She was evaluated for the causes of pathological fracture and the fracture was managed with hemi replacement of the shoulder because of the extensive bone loss. The pathology here could only be explained as some sequelae of hyper inflammatory state associated with COVID-19 infection. The possible differentials are also discussed here. This case report will help clinicians to consider COVID-19 infection as a cause for non-traumatic osteonecrosis among other reported causes of osteonecrosis.

Keywords: COVID-19; case report; metaphysis; osteonecrosis; pathological fracture.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • COVID-19* / complications
  • Female
  • Fractures, Spontaneous* / pathology
  • Humans
  • Humerus / pathology
  • Osteonecrosis* / etiology
  • Osteonecrosis* / surgery
  • Shoulder / pathology