Etiology of avascular necrosis of the hip and shoulder. Screening for Gaucher disease

• Published in: Revista clínica espanõla (English edition) 2023-01, Vol.223 (1), p.17-24
• Main Authors: Cuenca-Gómez, J.Á., Ocaña-Losada, C., Crujeiras, P., Rodrigues, D., Martínez-Espinosa, M.
• Format: Article
• Language: English
• Subjects: Avascular necrosis; Enfermedad de Gaucher; Etiological factors; Factores etiológicos; Female; Gaucher disease; Gaucher Disease - complications; Gaucher Disease - diagnosis; Gaucher Disease - epidemiology; Humans; Male; Middle Aged; Necrosis - complications; Necrosis avascular; Obesity - complications; Osteonecrosis; Osteonecrosis - diagnosis; Osteonecrosis - epidemiology; Osteonecrosis - etiology; Retrospective Studies; Shoulder
• ISSN: 2254-8874; 2254-8874
• DOI: 10.1016/j.rceng.2022.10.003

Avascular necrosis (AON) of the hip and shoulder is a little studied disease and the predisposing risk factors for its development are not well known. A high percentage of patients are diagnosed with idiopathic osteonecrosis. This study aims to investigate the prevalence of potential etiological factors for AON and to screen for Gaucher disease among patients with idiopathic AON. This retrospective, single-center, observational study was conducted on patients who had at least one episode of AON of the hip or shoulder at the Hospital de Poniente (Almería, Spain) from January 2010 to December 2019. Clinical and analytical data were collected. Patients whose medical record described no etiological factors for this disease were screened for Gaucher disease. The study sample consisted of 81 patients, of whom 58 were male. The mean age at presentation of AON was 45.9 years. They presented with unilateral hip necrosis (n=43), bilateral hip necrosis (n=34), bilateral hip and unilateral shoulder necrosis (n=3), and unilateral shoulder necrosis (n=1). The most frequent potential etiological factors were smoking (46.9%) and obesity (17.3%). Screening for Gaucher disease was performed in ten patients, all of whom tested negative. In our study population, the main potential etiological factors the onset of AON of the shoulder or hip were smoking and obesity. A high percentage of patients were diagnosed with idiopathic AON. We believe that a more exhaustive study of less frequent risk factors should be carried out in these cases. La osteonecrosis avascular (ONA) de cadera y de hombro es una enfermedad poco estudiada y no se conocen bien los factores de riesgos predisponentes para desarrollarla. Existe un porcentaje alto de pacientes diagnosticados como osteonecrosis idiopática. Este estudio tiene como objetivo investigar la prevalencia de los posibles factores etiológicos de la ONA y realizar un cribado de la enfermedad de Gaucher en los pacientes diagnosticados de ONA idiopática. Estudio observacional retrospectivo y unicéntrico de los pacientes que hayan presentado al menos un episodio de osteonecrosis avascular de la cadera o del hombro en el Hospital de Poniente (Almería, España) desde enero de 2010 a diciembre de 2019. Se recogieron datos clínicos y analíticos. Los pacientes en cuya historia clínica no se describían factores etiológicos fueron cribados para enfermedad de Gaucher. Se incluyeron un total de 81 pacientes, de los cuales 58 eran hombres. La edad media d