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Thursday, March 11, 2004

Osteonecrosis related to steroid, alcohol use common in multiple joints

Steroid-related and alcohol-related osteonecrosis tends to develop in multiple joints, while idiopathic osteonecrosis remains in a single joint, according to researchers for Poster Exhibit P001. Multiple osteonecrosis was defined as disease involving two or more separate anatomic sites. Researchers performed MRI screening for hip, knee, shoulder, and ankle joints (regardless of symptom) in patients with steroid-related, alcohol-related, and idiopathic osteonecrosis of the femoral head.

A total of 200 patients (104 women and 96 men) with femoral head osteonecrosis were followed. Of 151 patients with steroid-related osteonecrosis, 126 (83 percent) had bilateral hip involvement; of 36 patients with alcohol-related osteonecrosis, 25 (69 percent) had bilateral hip involvement. But among the 13 patients with idiopathic osteonecrosis, only six (46 percent) had bilateral hip involvement.

Researchers identified multiple osteonecrosis in 107 patients (54 percent). Of these patients, 92 (86 percent) had steroid-induced osteonecrosis and 15 (14 percent) had alcohol-related osteonecrosis. There was no multiple osteonecrosis in 21 idiopathic patients. The knee lesion was most common (96 patients), followed by the shoulder (28 patients) and the ankle (12 patients).

Between multiple osteonecrosis patients and non-multiple osteonecrosis patients, there were significant differences in age at diagnosis, gender and related factors. Multiple osteonecrosis tended to occur in young female patients with steroid-related osteonecrosis. The collapse rate was 27 percent for the knee, 25 percent for the shoulder and 17 percent for the ankle.

Investigators concluded that steroid-related and alcohol-related osteonecrosis tended to develop in multiple joints, unlike idiopathic osteonecrosis. Patients with ideopathic osteonecrosis also had a lower rate of bilateral involvement. This indicates that idiopathic osteonecrosis is not a systemic disease, but develops locally.

Researchers included Takashi Sakai, MD; Nobuhiko Sugano, MD; Hidenobu Miki, MD; and Kenji Ohzono, MD, all of Suita, Japan, and Takashi Nishii, MD; Masaki Takao, MD; and Hideki Yoshikawa, MD, of Osaka, Japan.

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2004 Academy News 2004 Academy News March 11 Index C

Last modified 20/February/2004