AB1303 AVASCULAR NECROSIS OF THE FEMORAL HEAD – NOT TO BE OVERLOOKED SEQUELA AFTER COVID 19 INFECTION

Background COVID 19 infection could lead to different sequelae in survivors, known as post-COVID or long syndromes. Some of them are thought be due the thrombophylic changes observed infection, but some caused by administrated (especially high dose) corticosteroid treatment. Avascular necrosis femoral head (AVNFH) is a multifactorial disease which leads compromised vascular supply, ischemia and finally head. As corticosteroids usage states among main risk factors for development AVNFH [1], it presumed that frequency this will increase with pandemic. The exact dose needed not clear, has been stated higher daily larger total cumulative substantially osteonecrosis [2]. Objectives To describe detail characteristics diagnosed patients after infection. Methods study was done tertiary university rheumatological clinic. Data extracted from records who have referred clinic because hip pain between June December 2022. Inclusion criteria were: - new onset uni-or bilateral started documented infection; an MRI scan joints showing one both heads. Exclusion were presence prior anamnesis traumatic injuries hips pelvis, personal history hypercoagulable states. Results Nine (4 women 5 men) average age 59.1 years (range 38-72) included study. Four had five – unilateral AVNFH, thus 13 analysed (8 left right sided). mean time lap start 26.2 weeks 10-48 weeks). All limited painful movement their symptomatic hip(s), especially internal rotation four also elevated CRP levels (mean 11.7 mg/L). stage evaluated according Ficat-Arlet classification (0-IV stage). In I, classified II remaining III. exhibited effusion/synovitis on ultrasound examination corresponding scan. It should noted effusion found related worse prognosis [1]. three amount required arthrocentesis fluid aspiration. analysis joint consistent degenerative (i.e., low WBC count predominant lymphocytes no crystals). our received during COVID19 while 6 hospitalized more severe disease. According patients’ documentation, 936.2 mg prednisolone equivalent per patient 187-2272 mg). Conclusion must overlooked Our results show suggestive osteonecrosis, they registered all patients. these two necessitates referral hips, order detected timely. References [1]Petek D, Hannouche Suva D. Osteonecrosis head: pathophysiology current concepts EFORT Open Rev. 2019 Mar 15;4(3):85-97. [2]Kerachian MA, Séguin C, Harvey EJ. Glucocorticoids understanding mechanisms action. J Steroid Biochem Mol Biol. 2009 Apr;114(3-5):121-8. Acknowledgements: NIL. Disclosure Interests PLAMEN TODOROV Speakers bureau: speaker at national level AbbVie, Novartis UCB, Lily Mekenyan: None declared, Anastas Batalov Speaker Novartis, Pfizer, Stada, Elly Lilly.