A case of bilateral hip and knee osteonecrosis in a patient with ankylosing spondylitis who used steroids due to immune thrombocytopenic purpura

We aim to present a case of bilateral hip and knee osteonecrosis due steroid use in an ankylosing spondylitis (AS) patient who developed immune thrombocytopenic purpura (ITP) after the nonsteroidal anti-inflammatory drugs (NSAID). A 60-year-old male was diagnosed with AS sacroiliitis inflammatory low back pain on sacroiliac radiography 10 years ago. He followed up NSAIDs. Intravenous treatment started hematology clinic had ITP NSAID usage. The presented our that therapy. limited joint movement destructive joints pelvic radiography. Bilateral total arthroplasty (THA) performed by Orthopedics Traumatology Department at 1-year intervals because associated use. When he 3 later pain, we detected distal segments femurs proximal tibial diaphysis MRI. implemented rehabilitation program conservative recommendation orthopedics. Comorbidities or drug side effects should be examined more carefully while treating peripheral involvement patients AS.