A 45-year-old was given steroids after renal transplant. After 2 years he had difficulty in walking and pain in both hips. Which one of the following is most likely cause -

This patient has : - History of steroids intake Pain in both hip Difficulty in walking The diagnosis is AVN of the hip. In 50% of idiopathic cases and 80% of steroid-induced AVN are bilateral. About other options Tuberculosis of hip is usually unilateral. Primary osteoarthritis of hip does not occur at 45 years and has nothing to do with steroid intake. Aluminium toxicity does not cause bilateral hip pain.