The Avascular Necrosis of Bone in Sle.
- Author:
Hyung In YANG
1
;
Bum Soon CHOI
;
Sung Hwan PARK
;
Sang Heon LEE
;
Chul Soo CHO
;
Ho Youn KIM
Author Information
1. Department of Internal Medicine, Lupus Clinic of Kangnam St. Mary's Hospital, Catholic University Medical College, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Avascular necrosis;
Systemic lupus erythematosus;
Corticosteroid
- MeSH:
Adult;
Female;
Humans;
Lupus Erythematosus, Systemic;
Lupus Nephritis;
Magnetic Resonance Imaging;
Osteonecrosis*;
Prevalence;
Retrospective Studies;
Vasculitis, Central Nervous System
- From:The Journal of the Korean Rheumatism Association
1996;3(2):118-125
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVE: To investigate the prevalence of avascular necrosis(AVN) of bone in SLE patients, and to examine the contributing factors of AVN. METHODS: 230 patients of 322 SLE patients fulfilling the 1982 ARA criteria of SLE were analysed for the steroid treatment and clinical manifestations. Their mean age was 33 years old. AVN was diagnosed by evidence of AVN in plain X-ray, bone scan and/or MRI. Retrospective analysis for medication history and clinical manifestations were performed. RESULTS: The rpevalence of AVN was 9.3%(30 patients of 322). All of the AVN patients were female and their mean age was 28 years old. Most common site of AVN was fernoral head(54.3%), other sites were distal femur(22%o) and proximal tibia(15%), proximal humerus(7%) and tarsal bone(2%), in order. 25 patients had multiple bony involvements. AVN was significantly associated with cutaneous vasculitis, CNS involvement and lupus nephritis. Recent(6 months before arthralgia) daily steroid dose of AVN(+) patients was higher than AVN(-) patients(15.2 mg vs 7.6mg p(0.05). Total mean daily steriod dose was not significantly different (20.3mg/d vs 12.3 mg/d) between AVN(+) and AVN(-). CONCLUSION: AVN is an important cause of musculoskeletal damage and disability in SLE. SLE patients with higher steroid treatment and major organ involvement need to be carefully evaluated for avascular necrosisl
