Studies in Sickle-Cell Anemia

Sickle-cell anemia (SCA) was first described in 1910,¹but involvement of osseous tissue in this disease was not reported until 1924, when Graham²autopsied a 30-year-old man and found the marrow cavity reduced in size and at one point obliterated. In 1927, Cooley³described a skull which on roentgenography showed widening of the diploic spaces, a thin or absent outer table, and parallel lines radiating from the inner table. Similar roentgenograms have subsequently been reported in other patients with SCA. More recently, there have been additional publications⁴⁻³²on bone involvement in SCA, but few of these report aseptic necrosis of the femur or the humerus. This paper presents two additional cases of aseptic necrosis of the femur in children with SCA. One of these cases also showed aseptic necrosis of the head of the humerus. Report of Cases Case1.—A 14-year-old Negro boy was hospitalized on