Hemodynamic evaluation of flow to the femur head in patients with systemic lupus erythematosus.
- Author:
Hyeon Jeong KIM
1
;
Ji Hyun OH
;
Kwang Soon AHN
;
Dong Gyu KIM
;
Mi Jeong SHIN
;
Choong Won LEE
Author Information
1. Department of Internal Medicine, Wallace Memorial Baptist Hospital, Busan, Korea. choong@wmbh.co.kr
- Publication Type:Original Article
- Keywords:
Osteonecrosis;
Systemic Lupus Erythematosus;
Ultrasonography;
Corticosteroid
- MeSH:
Arteries;
Femur Head*;
Femur*;
Hemodynamics*;
Hip;
Humans;
Lupus Erythematosus, Systemic*;
Necrosis;
Osteonecrosis;
Risk Factors;
Ultrasonography
- From:Korean Journal of Medicine
2005;69(2):183-189
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: One of the groups with highest risk for avascular necrosis is patient with systemic lupus erythematosus (SLE). Corticosteroid therapy is also the most important risk factor. No predictive test, however, was known to detect avascular necrosis. The purpose of this study is to evaluate hemodynamic flow to the proximal femur in patients with SLE with long term corticosteroid therapy. METHODS: Twenty-two patients with SLE without avascular necrosis and with long-term corticosteroid treatment (mean months; 41 (1-156)) versus 15 healthy controls were evaluated. Medial and lateral circumflex arteries of 44 hips in 22 SLE patients and 30 hips in healthy controls were examined using ultrasoud equipment with color Doppler and power Doppler capability. Arterial pulstality index (PI) and peak systolic velocity (PSV) were determined with neutral and internal rotation position (stimulated ischemia). RESULTS: PSV was significantly increased in patients with SLE than healthy controls (70.6+/-40.4 vs 46.9+/-19.3; p<0.001) with neutral position as well as (74.8+/-42.3 vs 49.9+/-19.9; p<0.001) with internal rotation. PI was also higher in SLE patients than healthy controls (8.9+/-6.3 vs 5.5+/-3.4; p<0.001) with neutral position as well as (8.1+/-7.1 vs 3.9+/-2.5; p<0.001) with internal rotation. PI strongly correlated with PSV (r=0.99, p<0.001). But PSV or PI did not correlate with duration of corticosteroid use. CONCLUSION: Peak systolic velocity and pulstality index of arteries to the femur head in patients with SLE with long-term corticosteroid treatment were significantly higher than healthy controls. These hemodynamic changes may contribute to develop avascular necrosis of the hip in patients with SLE.
