A patient with sickle cell disease is at risk of developing osteonecrosis of one or more bones.
Common joints affected:
(1) knee
(2) hip (femoral head), often bilateral
(3) shoulder (head of the humerus)
Risk factors for osteonecrosis:
(1) vaso-occlusive and/or painful crisis
(2) leg ulcer
(3) impaired fibrinolytic activity
(4) elevated MCHC (or hemoglobin to hematocrit ratio > 0.33)
Risk factors for complications:
(1) occurrence during childhood
(2) bacteremia (with osteomyelitis)
(3) extent of necrosis
Complications:
(1) osteomyelitis
(2) osteoarthritis
(3) severe pain
(4) disability
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Specialty: Surgery, orthopedic
