Aseptic necrosis of the head of the femur among sickle cell anaemia patients in Uganda.

A number of HbSS patients presenting with aseptic necrosis of the femoral head have been seen at Mulago Hospital in Kampala, Uganda. A record review of the hospital's Sickle Cell Anaemia Clinic for the period 1985-1989 revealed that aseptic necrosis of the femoral head has been diagnosed in 2.9% (47/1611) of patients attending regularly. The largest number of diagnosed patients were in the 15-24 year old age group; peak incidence occurred in 20-24 year old women. Diagnosis in this series of patients was generally delayed and management was accordingly difficult. It is suggested that clinicians ask directly about pain in the hip of sickle cell patients rather than waiting spontaneous reporting. Such an approach may improve early detection of this potentially crippling problem.