Dexamethasone Overuse and Its Impact on Knee Health

In Eastern Morocco, a 32-year-old woman faced severe knee issues. She had been using high doses of dexamethasone for a long time. This led to a serious condition called osteonecrosis in both her knees. This condition can cause the knee joint to break down over time, making it hard to move around. Osteonecrosis is not common, but it can be very serious. When it happens because of too much corticosteroid use, it can be tricky to spot and treat. The woman had pain, stiffness, and trouble moving her knees. Doctors used MRI scans to see the damage. They found clear signs of osteonecrosis in both the thighbone and shinbone of her knees. Tests ruled out other possible causes like infections or blood disorders. Since the damage was so bad and the patient did not want surgery, doctors chose a different approach. They focused on physical therapy, changing her lifestyle, and managing her pain. This case shows how dangerous it can be to use corticosteroids without proper guidance. It also shows why it is important to catch problems early and use the right tools to check for joint damage. This is the first known case in Eastern Morocco where dexamethasone use led to such widespread knee damage. It adds important information to what is known about how corticosteroids can harm muscles and bones. Dexamethasone is a type of corticosteroid. It is often used to reduce inflammation and suppress the immune system. However, long-term use or high doses can lead to serious side effects. One of these side effects is osteonecrosis, which occurs when blood flow to a bone is reduced. This can cause the bone to die and eventually collapse. In the case of the knee, this can lead to severe pain, stiffness, and difficulty moving. The woman in this case had been self-medicating with high doses of dexamethasone. This led to osteonecrosis in both her knees, affecting both the thighbone and shinbone. This is a rare but serious condition that can be difficult to treat. Doctors used MRI scans to confirm the diagnosis. They found characteristic signs of osteonecrosis, including a wavy border and a double line sign in the affected bones. The woman had been experiencing chronic knee pain, stiffness, and functional limitation. These symptoms are common in people with osteonecrosis. However, the exact cause of her condition was not clear at first. Doctors had to rule out other possible causes, such as infections, inflammatory conditions, and blood disorders. Once they confirmed that the woman's osteonecrosis was caused by dexamethasone overuse, they had to decide on a treatment plan. Given the extent of the damage and the woman's refusal of surgery, doctors chose a conservative approach. This involved physical rehabilitation, lifestyle changes, protected weight-bearing, and pain management. This approach aims to improve the woman's quality of life and slow down the progression of the disease. However, it is important to note that there is no cure for osteonecrosis. The best way to prevent it is to avoid overusing corticosteroids and to seek medical advice before starting any new medication. This case highlights the importance of early recognition, comprehensive patient history, and timely imaging to prevent severe joint degeneration. It also adds valuable insight to the literature on corticosteroid-induced musculoskeletal complications. The woman's case is unique because it involves extensive topographic involvement. This means that the osteonecrosis affected a large area of both her knees. This is not common in cases of corticosteroid-induced osteonecrosis. Most cases involve only one knee or a smaller area of the knee. The woman's case also highlights the importance of seeking medical advice before starting any new medication. Self-medicating with high doses of dexamethasone can lead to serious side effects, including osteonecrosis. It is important to remember that even over-the-counter medications can have side effects. Always talk to a healthcare provider before starting any new medication. This case also shows the importance of early recognition and timely imaging. Osteonecrosis can be difficult to diagnose, especially in its early stages. However, early diagnosis and treatment can improve outcomes and prevent severe joint degeneration. This case adds valuable insight to the literature on corticosteroid-induced musculoskeletal complications. It highlights the need for more research on this topic and the importance of raising awareness among healthcare providers and patients.