To the Editor.—
In a recent article in the Archives (138:750-754, 1978), Dr Abeles and coauthors associated high corticosteroid doses with the development of aseptic necrosis of bone; however, small doses seem to have a similar effect.A 44-year-old man is under my care who had received a total left hip replacement for aseptic necrosis a few months ago. In 1974 the patient had a chromophobe pituitary adenoma removed and has taken 7.5 mg of prednisone daily since this time. He has never had any large dosage of cortisone. He is hypertensive and suffered a mild stroke about one year ago. It is possible that the reduced activity owing to the right-sided paresis, the stress of placing the body weight to the left side, and a gonadal deficiency that is due to hypopituitarism have also contributed to the development of the aseptic necrosis of his left hip joint.