Necrosis avascular bilateral de la cabeza del fémur

Avascular necrosis of the femoral head results from disrupted blood supply leading to bone death and joint collapse.We report the case of a 60-year-old man with chronic kidney disease on hemodialysis, with diabetes mellitus and hypertension, without trauma or corticosteroid exposure. He presented with progressive bilateral hip pain and functional limitation. Radiographs revealed subchondral cysts and bilateral femoral head collapse consistent with advanced avascular necrosis of the femoral head. Chronic kidney disease-related hypoxia, metabolic abnormalities, and uremic toxins likely contributed to osteonecrosis. Bilateral total hip arthroplasty in staged procedures was recommended.This case emphasizes the need to consider this type of necrosis in hemodialysis patients presenting with non-traumatic hip pain, especially given the rare and clinically significant bilateral involvement, which severely impacts mobility and quality of life.