PMC4925909_01
Progress information of the patient. Because of recurrence of Vogt-Koyanagi-Harada (VKH) syndrome, the patient received 3 courses of systemic steroid pulse therapy in 1 month. ONFH, osteonecrosis of the femoral head; MRI, magnetic resonance imaging.
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Administration of corticosteroid was gradually tapered to 5 mg/day and switched to low-dose oral drugs (Fig. 1).
Magnetic resonance imaging obtained after the onset of bilateral groin pain. There were no significant findings.
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An orthopedic doctor suspected a case of steroid induced ONFH; however, there were no abnormal signs in the MRI scan of the hip joints and physical examination (Fig. 2).
Right osteonecrosis of the femoral head could be diagnosed by magnetic resonance imaging (MRI). Characteristic band pattern was shown (yellow arrows). The scout view of T2-weighted MRI (A) and T1-weighted MRI (B).
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T2-weighted MRI showed a characteristic band image consistent with ONFH. Thus, she was diagnosed with stage 1 ONFH in the right hip (Fig. 3).
A schema and radiological results of the regenerative therapy. Dashed yellow lines show the border of ONFH area. (A) A schema of the surgical procedure administering the rhFGF-2 gelatin hydrogel by the percutaneous technique. The actual hydrogel (small photograph). (B) A screenshot used for preoperative planning. The area of osteonecrosis of the femoral head (ONFH) is shown in yellow. The route of the drilling is shown by the blue screw. Pre-operative magnetic resonance imaging (MRI) (C) and 2-year postoperative radiographs show bone formation within the ONFH area: radiograph (D), computed tomography (CT) image (E), and T1-weighted MRI (F).
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Radiographs, computed tomography images, and MRI showed bone regeneration in the area of ONFH (Fig. 4).