Bilateral Osteonecrosis of the Femoral Head Associated with Corticosteroid Therapy for Alopecia Areata: A Case Report and Review of the Literature

A 23-year-old woman developed bilateral osteonecrosis of the femoral head (ONFH) after receiving corticosteroid therapy for alopecia areata (AA). Despite various treatments, including high-dose corticosteroids, her AA progressed, leading to ONFH, diagnosed as stage three postcollapse on the right and stage one precollapse on the left. She underwent total hip arthroplasty for the right hip and joint-preserving surgery for the left. This case underscored the severe risk of ONFH with corticosteroid use, emphasizing the need for early detection through MRI and careful monitoring to prevent femoral head collapse. The findings highlighted the importance of weighing the benefits and risks of corticosteroid therapy in treating AA.