This investigation evaluated the detection rate of osteonecrosis in a large series of consecutively evaluated patients with inflammatory bowel disease, specifically Crohn’s dis­ease. Of the 877 patients seen by a single clinician over 20 years in a referral-based tertiary care university teaching hospital setting, osteonecrosis was detected in four patients for an overall rate of [...]

Potential risk factors for osteonecrosis: Several possible risk factors for osteonecrosis were independently evaluated. These are schematically shown in Figure 1. Risk factors in­cluded use of corticosteroids, use of parenteral nutrition (all administered solutions included lipid emulsions), or con­comitant corticosteroid and parenteral nutrition. In addi­tion, because nutrient absorption may be a factor in the pathogenesis [...]

Osteonecrosis rates: The records of 877 patients with Crohn’s disease seen during a 20-year period were retrospec­tively analyzed to determine the frequency of osteonecrosis and possible factors that might have influenced its develop­ment. This represented the entire clinical experience of a sole gastroenterologist in a tertiary care university teaching hospital. Of these 877 patients, 492 [...]

Case 3: A 36-year-old man presented with an ischiorectal abscess that required incision and drainage in 1989. Because of diarrhea and a weight loss of 20 kg, further investigations were done. Fecal cultures and studies for parasites were nega­tive. Colonoscopy showed superficial and deep serpentine ulcers, mucosal swelling, erythema, friability and pseudopol- yps in the [...]

Case 2: A 29-year-old man first developed diarrhea, up to 10 watery movements daily, in 1983. Colonoscopic evaluation in a community hospital showed colitis with deep ulcera- tions, thought to be consistent with Crohn’s colitis. He was treated with sulphasalazine 2 g daily and corticosteroid ene­mas. His symptoms improved, but he had occasional epi­sodes of [...]

Clinical records of 877 patients with Crohn’s disease were retrospectively reviewed by the authors. Four patients with osteonecrosis were found, including two who were previ­ously reported elsewhere. Follow-up data were available, with a mean for the entire patient group of 7.8 years. Osteonecrosis was diagnosed on the basis of routine radio- graphic studies and nuclear [...]