For a study, it was determined that avascular necrosis (AVN) was linked with considerable morbidity. It included the potential for severe pain and impairment; people with inflammatory bowel disease (IBD) had a greater frequency of AVN than non-IBD populations. Researchers wanted to establish the prevalence of AVN in the IBD group and to look for clinical features associated with AVN on computed tomography (CT) imaging. Researchers found 27 patients (2.1%) had CT abnormalities compatible with AVN in 1,313 IBD patients with abdomen/pelvis CT scans. Researchers validated that most patients had past steroid exposure by a review of their medical records, with the exception of two patients who had no recorded steroid exposure at all.
Researchers also discovered that 59% of contemporaneous radiological reports did not mention the existence of AVN, implying that incidental CT observations of AVN in IBD patients are likely underreported. Notably, they discovered that 63% of these individuals had documented low-back and/or hip discomfort. They found a link between anti-neutrophil cytoplasmic antibody-positive status across IBD (P=0.007) and smoking history in Crohn’s disease (P=0.03) and the occurrence of AVN using logistic regression.
They discovered that a high number of IBD patients with AVN had hip or low-back pain in their records, and a review of CT imaging under specialized bone windows revealed AVN in this cohort.
