Basic Information

Patient name: H. V.
Age: 46 years old
Gender: Male
Occupation: Teacher

Medical History

Anamnesis: 46-year-old patient presents at Hyperbarium clinic with a diagnosis of Aseptic necrosis of the right femoral head, stage III.
Family history: None known.

Clinical Presentation:

Symptoms: Pain in both hips.
Duration: Several months.
Aggravating factors: Obesity.
Alleviating factors: None.

Treatment History:

Current medications: Nonsteroidal anti-inflammatory drugs as needed.
Previous treatments: None.

Investigations:

Results: Pelvic MRI.
Diagnosis: Aseptic necrosis of the femoral head, stage III, right side.

Treatment Plan:

Recommended medication: None prescribed.
Therapeutic interventions: Hyperbaric therapy: initial protocol - 20 sessions, followed by reassessment.

Evolution and Prognosis:

Evolution: Favorable.
Prognosis: Good, with increased chances of complete functional recovery following continued treatment and periodic monitoring.
Result: At reassessment, a 50% reduction in edema was found, clinically correlated with a decrease in pain from an initial 9/10 to 6-7/10 post-treatment. Also, an improvement in mobility of approximately 40% was observed. Continuation of hyperbaric therapy is recommended.
After the second treatment cycle, the patient reports that the pain, initially evaluated at 8-9/10, has reduced to 2-3/10. Pain only occurs during intense effort, while at rest and during moderate effort, the pain has disappeared. Sleep has become restful, as the patient can sleep on his hips without feeling discomfort.

Final Observations:

Both imaging and clinical findings reveal a 90% healing with remission of edema and preservation of geodes. A follow-up MRI is recommended after one year and reassessment as needed, along with weight reduction, to maintain a healthy and balanced lifestyle.