Osteonecrosis in patients with systemic lupus erythematosus

Oh, Saelin; Jee, Won Hee; Cho, S.M; Kim, S.H; Kang, Heung Sik; Ryu, Kyung Nam; Cho, C.S

doi:10.1016/s0899-7071(03)00192-x

Cited by 21 publications

(13 citation statements)

References 17 publications

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“…Osteonecrosis of the femoral head (ONF) has been reported in up to 10% of cases of patients with SLE (261, 262). Factors associated with osteonecrosis in SLE patients include hypercoagulability manifested by venous thrombosis, vasculitis, corticosteroid use, the presence of arthritis, and the use of cytotoxic medications (263, 264).…”

Section: Sle and Bonementioning

confidence: 99%

Rheumatic diseases: the effects of inflammation on bone

Walsh

Crotti

Goldring

et al. 2005

Immunological Reviews

349

262

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Rheumatoid arthritis, juvenile idiopathic arthritis, the seronegative spondyloarthropathies including psoriatic arthritis, and systemic lupus erythematosus are all examples of rheumatic diseases in which inflammation is associated with skeletal pathology. Although some of the mechanisms of skeletal remodeling are shared among these diseases, each disease has a unique impact on articular bone or on the axial or appendicular skeleton. Studies in human disease and in animal models of arthritis have identified the osteoclast as the predominant cell type mediating bone loss in arthritis. Many of the cytokines and growth factors implicated in the inflammatory processes in rheumatic diseases have also been demonstrated to impact osteoclast differentiation and function either directly, by acting on cells of the osteoclast-lineage, or indirectly, by acting on other cell types to modulate expression of the key osteoclastogenic factor receptor activator of nuclear factor (NF) kappaB ligand (RANKL) and/or its inhibitor osteoprotegerin (OPG). Further elucidation of the mechanisms responsible for inflammation-induced bone loss will potentially lead to the identification of novel therapeutic strategies for the prevention of bone loss in these diseases. In this review, we provide an overview of the cell types, inflammatory mediators, and mechanisms that are implicated in bone loss and new bone formation in inflammatory joint diseases.

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Section: Sle and Bonementioning

confidence: 99%

Rheumatic diseases: the effects of inflammation on bone

Walsh

Crotti

Goldring

et al. 2005

Immunological Reviews

349

262

View full text Add to dashboard Cite

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“…Osteonecrosis often involves more than one skeletal site; a case of SLE with twelve simultaneous osteonecrotic lesions was reported [18]; long-bone epiphyses are usually involved, but flat bones as ilium, sternum, talus, and vertebral bodies may be affected too [10, 19]. When osteonecrosis at one skeletal site is found in a SLE patient, a screening for other concomitant lesions is generally recommended since multifocal involvement is not infrequent.…”

Section: Introductionmentioning

confidence: 99%

Osteonecrosis in Systemic Lupus Erythematosus: An Early, Frequent, and Not Always Symptomatic Complication

Caramaschi

Biasi

Forno

et al. 2012

Autoimmune Diseases

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Osteonecrosis may complicate the course of systemic lupus erythematosus and may contemporaneously affect multiple joints. The major risk factor associated with the development of osteonecrosis is the use of glucocorticoid at high doses. Recent studies using serial MRI, which represents the “gold standard” for the early detection of osteonecrosis, yielded some interesting findings about the natural history of this clinical entity. Osteonecrosis in the majority of the cases is asymptomatic and occurs early in the course of the disease. Its later occurrence is associated with lupus flare that requires the increase of corticosteroid dose. The optimal treatment of osteonecrosis is controversial. In case of silent osteonecrosis involving a small area conservative strategy is usually adequate. When lesions are symptomatic surgical treatment as core decompression or free vascularized fibular grafting is required; extracorporeal shockwave treatment may represent an alternative therapeutic approach. When the lesion has a medium-large dimension or involves a weight-bearing area bone collapse is a common complication requiring total joint replacement. Coadministration of bisphosphonate or warfarin with high doses of corticosteroid might be a promising preventive strategy of osteonecrosis.

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“…Although femoral head is the most common site of involvement, multiple osteonecrosis may be seen in humeral head, around both knees and ankles, appearing as multiple segmental increased uptake lesions on whole body bone scan ( Figure 6) [22].…”

Section: ) Clinical Applicationsmentioning

confidence: 99%

Nuclear Medicine Imaging in Rheumatic Diseases

Choi

Kim

2017

J Rheum Dis

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The rapid development of medical imaging technologies has greatly enhanced the utility of nuclear medicine imaging modalities over the last decade. Hybrid imaging technology merging computed tomography (CT) with single-photon emission computed tomography (SPECT) or positron emission tomography (PET) allows superimposing the physiologic data obtained by SPECT or PET on the detailed anatomy of CT, yielding a better understanding of the disease status and improving diagnostic performance. However, the conventional whole body bone scan and three phase bone scan still have their own distinct role as diagnostic imaging, reflecting the changes of bone metabolism in benign and malignant diseases, including rheumatic diseases. A review of each nuclear medicine imaging technique and clinical applications in various conditions of rheumatic diseases will be presented in this article. (J Rheum Dis 2017;24:4-13)

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Osteonecrosis in patients with systemic lupus erythematosus

Cited by 21 publications

References 17 publications

Rheumatic diseases: the effects of inflammation on bone

Rheumatic diseases: the effects of inflammation on bone

Osteonecrosis in Systemic Lupus Erythematosus: An Early, Frequent, and Not Always Symptomatic Complication

Nuclear Medicine Imaging in Rheumatic Diseases

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