DYSPLASIA OF THE HIP AS A COMPLICATION OF SICKLE-CELL-ANEMIA

Eighty-four hips of sickle cell anemia patients were followed up durin g adulthood after the occurrence during childhood of avascular necrosi s of the femoral head. Roentgenograms showed residual dysplasia at com pletion of growth in a substantial number of cases: coxa magna was fou nd in 11 hips, coxa plana or loss of capital sphericity in 53 hips, an d true osteochondritis in 3 hips. Only 20 hips exhibited normal morpho logical features at completion of growth. Anomalies were found not onl y in the proximal femur but also in the acetabulum which was altered i n 14 hips (inadequate lateral coverage in 8 hips and protrusion in 6). Roentgenological changes suggested that the acetabular alterations we re due to triradiate cartilage lesions directly produced by the blood disorder rather than to the effects of the femoral alterations. The an omalies seen also suggested that the adverse effects of sickle cell an emia on growth involve not only epiphyseal ossification centers but al so growth plates.