Humeral head osteonecrosis in sickle cell disease

Sickle cell disease is the commonest cause of humeral head osteonecrosis worldwide. 144 shoulders in 72 patients with sickle cell disease were assessed clinically and radiographically. Our null hypothesis is that there is no correlation between the shoulder symptoms and the radiographic extent of osteonecrosis in such patients. The symptoms of each shoulder were scored using the UCLA shoulder scoring system. All shoulder x-rays were staged for humeral head osteonecrosis according to the modified Ficat and Arlet staging system. The Wilcoxin ranked sum test was used to correlate the data of the UCLA score with the data of the modified Ficat and Arlet stage. This gave a coefficient of 0.189. It is concluded that there is most likely no correlation between the shoulder symptoms and the radiographic stage of humeral head osteonecrosis in patients with sickle cell disease