case_images: PMC10858799_01
case_images: Imaging evaluation findings. A) Frontal radiography of the hip joint; B) Frontal radiography of the hip joint during abduction. No impingement of the acetabulum is observed during abduction of the right femoral head; C) Coronal computed tomography of the hip joint; D) Transverse computed tomography of the hip joint is shown. Bone sclerosis is observed in the right femoral head, and the necrotic bone is remodeled; E) Coronal T1-weighted magnetic resonance imaging; F) Coronal fat-suppressed magnetic resonance imaging reveals no signs of inflammation.
case_images: cureus-0016-00000052120-i01.jpg
case_images: PMC10858799_01_cureus-0016-00000052120-i01.jpg
case_images: FIG1
case_images: All the images were taken at the time the Department of Rehabilitation was consulted (Figure 1). A frontal radiograph revealed mild flattening of the right femoral head, though no arthropathic changes were observed (Figure 1A). The flattened head did not impinge on the acetabulum, indicating that the limitation of range of motion was not bony in origin but soft tissue-induced, mainly due to contractures (Figure 1B). Computed tomography (CT) revealed that the necrotic area of the head was remodeled (Figures 1C and 1D), and no inflammatory findings were observed on magnetic resonance imaging (Figures 1E and 1F).
case_images: Medical history and rehabilitation program. ROM - range of motion; ALL - acute lymphoblastic leukemia
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case_images: PMC10858799_01_cureus-0016-00000052120-i02.jpg
case_images: FIG2
case_images: As the contractures improved, exercise therapy centering on joint range-of-motion training and muscle-strengthening training was implemented step by step, and endurance-strengthening training using an ergometer was also performed (Figure 2).   Although the gait abnormality persisted, the patient showed marked improvement and was able to ride a bicycle and travel (Figure 2). The patient's activity level significantly improved, and she has returned to work, married, had a baby, and is leading an active social life (Figure 2).