J Korean Rheum Assoc.
1996 Jul;3(2):118-125.
The Avascular Necrosis of Bone in Sle
- Affiliations
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- 1Department of Internal Medicine, Lupus Clinic of Kangnam St. Mary's Hospital, Catholic University Medical College, Seoul, Korea.
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
