Multiple sites of ischemic necrosis of bone following long term corticosteroid treatment in a patient with auto-immune granulocytopenia.

A 36-year-old white male suffering from auto-immune granulocytopenia with recurrent infections and subsequent systemic AA-amyloidosis developed ischemic necrosis of bone (INB) in several joints following long-term corticosteroid treatment. Early signs of INB in one joint were detected by Magnetic Resonance Imaging and joint damage could be prevented by core decompression. The importance of early detection of INB Magnetic Resonance Imaging is stressed. According to the present theory regarding the pathogenesis of INB, amyloidosis might contribute to intra- as well as extra-osseous factors. However, no relation was found between amyloidosis and INB.