[Radiographic aspects of aseptic osteonecrosis following renal transplantation. Apropos of 65 localizations in 30 patients].

The authors report 30 cases of aseptic osteonecrosis in 65 different bones, including 37 hips, 13 knees, 5 taluses, 1 cuboid, 8 shoulders, 1 humeral condyle, following renal transplantation. One patient had osteonecrosis in six different bones. In 24 cases, the necrosis occurred before the end of the 18th month following the graftmin 21 cases, radiodiagnosis of the first localisation was made before the end of the first month following the first clinical sign. The usual presenting symptom of osteonecrosis is a clear, sub-chondral crescent. In 2/3rds of cases of osteonecrosis of the femoral neck, there is a rapidly destructive form often well tolerated clinically. In 1/3rd of cases, the course was slow with mainly osteocondensation. The course is particularly destructive when, following failure of the graft, the transplanted patient is submitted to periodic hemodialysis. In 8 cases, the femoral condyles were involved, and in 4, the tibial condylesm the appearance may be that of osteochondritis dissecans, but more often the course resembles the destructive form of aseptic necrosis of the femoral head. Shoulder involvement leads to a radiological picture identical with that of the hips. One transplanted patient out of 5, has a chance to develop osteonecrosis within two years following the graft.