ヘモジデリン沈着性滑膜炎（Hemosiderotic Synovitis）の所見を呈した特発性大腿骨頭壊死症の１例

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  • Idiopathic Osteonecrosis of the Femoral Head Accompanied by Hemosiderotic Synovitis: A Case Report
  • ヘモジデリン チンチャクセイカツマクエン Hemosiderotic Synovitis ノ ショケン オ テイシタ トクハツセイ ダイタイコットウ エシショウ ノ 1レイ

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 This case report concerns a 44-year-old man who developed idiopathic osteonecrosis of the femoral head (ION), for which total hip arthroplasty was performed. The patient developed pure red cell aplasia (PRCA) at 33 years old and received steroid pulse medical treatment for this condition. Internal use of steroid medicine was continued for 6 years. The patient needed frequent red blood cell transfusions, receiving on average 1200 ml a month to improve anemia resulting from PRCA, but developed hemochromatosis and ION. To treat the left hip joint disorder, total hip arthroplasty was performed. Histologically, the synovium of the hip joint was papillary, and hemosiderin was deposited in this. We diagnosed this synovitis as hemosiderotic synovitis. In this case, nonconformity of the morphology of the joint was found along with denaturation of the cartilage as a result of ION. The possibility of synovitis and arthropathy were associated with internal hemorrhage of the joint, grit necrosis, immunoreaction caused by the damaged organization, and hemochromatosis.

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