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Severely Damaged Hip Joints from Avascular Necrosis in a Patient with Sickle Cell Trait: Case Report

Derrick Tembi Efie, Nkeangu Fomengia Joseph, Eugene Vernyuy Yeika, Siméon Pierre Choukem

Background: Avascular necrosis of the femoral head is an increasingly recognized entity especially in the context of sickle cell disease. This entity is however less frequently seen in sickle cell trait; consequently, fewer cases of hip damage secondary to avascular necrosis in persons with sickle cell trait have been reported. This case shows how avascular necrosis can occur, affecting both hip joints in patients with sickle cell trait.

Case presentation: We present the case of a 13-year-old Black African male with sickle cell trait who presented with a 1-year history of progressive bilateral hip pain and deformity. He was diagnosed with bilateral avascular femoral head necrosis and benefited from analgesics and physiotherapy.

Conclusion: Avascular necrosis of the head of the femur is a complication often seen in patients with sickle cell disease but rarely in those with sickle cell trait. This case report shows the infrequent presentation of avascular femoral head necrosis in the context of sickle cell trait and also the limitation of low resource settings in performing hip replacement surgeries and other curative treatment options for this disabling and debilitating condition.