Spontaneous bilateral avascular necrosis of knees and hip leading to early bilateral total hip arthroplasty: a case report of an 18-year-old man recently diagnosed with Crohn's disease

Abstract

Avascular necrosis (AVN) is linked to considerable morbidity, resulting in severe pain and functional impairment. Herein, for the first time, we reported an 18-year-old patient with Crohn's disease during the remission phase under Azathioprine therapy who presented with articular pain. Although no underlying risk factors, the patient was diagnosed with severe AVN of the bilateral femoral head and both knees simultaneously following pain in involved areas. This case highlights the importance of demand multidisciplinary approach to chronic disease. Moreover, clinicians should be aware of articular manifestations in IBD patients to diagnose and treat these conditions as soon as possible. Patients should be evaluated for their psychologic, gastrointestinal, and extra-gastrointestinal comorbidities during each follow-up visit.

Keywords: Avascular necrosis; Crohn’s disease; Inflammatory bowel disease; Lower back pain; Osteonecrosis.