Corticosteroid Usage and Osteonecrosis of the Hip

The disease process of atraumatic osteonecrosis was first described as ischemic necrosis of the hip [1]. This pathological process can lead to destructive arthritis in multiple joints, most commonly occurring in the hips, knees, shoulders, and ankles [1]. Currently, there is no consensus on the pathophysiological mechanism of osteonecrosis, but it is thought to be multifactorial in nature. However, there are certain direct risk factors implicated in the development of osteonecrosis such as trauma, radiation, Caisson’s disease, and sickle cell disease [2]. In addition, various other risk factors have been shown to have a direct correlation with osteonecrosis such as corticosteroids, habitual alcohol intake, hyperlipidemia, chemotherapeutic agents, systemic lupus erythematosus (SLE), lipid storage diseases, and inflammatory bowel disease [3, 4].