Drepanocitosi e osteonecrosi avascolare della testa del femore

A 10.5-year-old girl with homozygous sickle cell disease on chronic treatment with hydroxyurea, blood transfusions and erythroexchange presented with sudden right thigh pain and limping, without trauma or fever. Imaging and lab results indicated avascular necrosis (AVN) of the femoral head. Initially, she was treated with empirical antibiotics, underwent exchange transfusion and was prescribed limb rest. Furthermore, hyperbaric therapy and potential conservative surgical intervention were considered. AVN is a known complication of sickle cell disease, driven by vaso-occlusive events, genetic factors and potentially low-dose corticosteroid use. Early MRI diagnosis is crucial for initiating conservative treatment and delaying joint replacement.