David H G, Bridgman S A, Davies S C, Hine A L, Emery R J
Central Middlesex Hospital, London, England.
J Bone Joint Surg Br. 1993 Jul;75(4):538-45. doi: 10.1302/0301-620X.75B4.8331106.
Sickle-cell disease (SCD) is probably the commonest cause of avascular necrosis worldwide, and its prevalence appears to be rising in developed countries. Avascular necrosis of the humeral head is a common complication but has not been previously studied in detail. We have reviewed 138 patients with SCD for clinical, radiological and functional abnormalities of the shoulder, using a radiological classification designed for avascular necrosis of the shoulder. Radiographic lesions, frequently bilateral, were found in 28% and only 53% of patients had normal shoulder function. The management of this relatively common complication is difficult. Joint replacement is likely to fail and early diagnosis is important.
