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Sore Hip Joints
Mar 11, 2001

Dear Doctors: Thank you for the wonderful service you provide in this forum! My question: I had a really sore right hip joint for two days last week. Since then, it has calmed down, but, both hip joints are mildly sore through the day. At night, if I roll over on either side, the hip joint on that side begins to hurt, and the pain wakes me up. I have been HIV+ for 17 years and on HAART cocktails (containing protease inhibitors) for the past 5 years. I also started testosterone replacement therapy (the gel formulation) a little over one month ago. I am wondering if the testosterone could be causing the hip joint pain, or whether it is early signs of avascular necrosis. I have read in several sources recently that avascular necrosis (bone death due to lack of blood supply to the bone) is being seen increasingly in the context of HIV+ individuals, especially those on HAART. Do you think it would be wise to ask my doctor to schedule an MRI to check whether early detoriation of the bone in my hip joints is occurring? Or, should I knock off the testosterone for a while to see if the pain eases up? (The testosterone really hasn't given me much relief from my fatigue or depression - a recent blood test should tell me soon where my testosterone level is.) Also, should I begin a course of ibuprofen to address any inflammation that may be getting started in the hip joints? Any insight you might offer me would be greatly appreciated. This is beginning to worry me.

Response from Dr. Henry

Ibuprofen should be OK for now assuming that you don't have a history of stomach ulcers or kidney failure. Plain X-rays of the hip joint are often enough to evaluate for aseptic necrosis of the hips which is something I would bet checked for with the symptoms you described. I doubt that the testosterone is causing that. KH

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