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Knee pain in lupus patients, what do you think about it?
Knee pain in lupus patients, what do you think about it?The assistant has learned about a patient with lupus for 10 yea.
The assistant has learned about a patient with lupus for 10 yea.
Aspect 01
What is osteonecrosis?
What is osteonecrosis?Osteonecrosis literally means "death of the bo.
Osteonecrosis literally means "death of the bo.
Osteonecrosis is associated with many factors, currently recognized risk factors are glucocorticoid use and long-term alcohol abu.
Aspect 02
systemic lupus erythematosus osteonecrosis
systemic lupus erythematosus osteonecrosisOsteonecrosis (also known as avascular, aseptic, or avascular necrosis) is most common in the femoral head in patients with systemic lupus erythematosus (SLE), but may also occur in the humeral head, tibial plateau, and scapho.
Osteonecrosis (also known as avascular, aseptic, or avascular necrosis) is most common in the femoral head in patients with systemic lupus erythematosus (SLE), but may also occur in the humeral head, tibial plateau, and scapho.
The literature shows that about 3 to 40% of SLE patients will develop osteonecros.
Currently, disease activity measured by the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) score is considered to be the main risk factor for osteonecrosis in early S.
Currently, disease activity measured by the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) score is considered to be the main risk factor for osteonecrosis in early S.
Early lesions of osteonecrosis can be detected by MRI, whereas plain radiography can only detect late lesio.
Currently we generally only perform MRI in patients with suggestive symptoms such as hip or groin pa.
Risk factors for osteonecrosis in systemic lupus erythematosus
Risk factors for osteonecrosis in systemic lupus erythematosusOsteonecrosis begins with the interruption of blood supply to the bone, and subsequently, adjacent areas become congested, leading to demineralization, thinning of the trabeculae, further elevation of intramedullary pressure, and collapse of the bo.
Osteonecrosis begins with the interruption of blood supply to the bone, and subsequently, adjacent areas become congested, leading to demineralization, thinning of the trabeculae, further elevation of intramedullary pressure, and collapse of the bo.
SLE patients taking glucocorticoids are at greatest risk (a minority of SLE patients have osteonecrosis without glucocorticoid therap.
In a prospective study evaluating 60 patients with SLE over five years, patients without MRI abnormalities in the femoral head during the first year of follow-up were less likely to develop osteonecrosis later in li.
In a prospective study evaluating 60 patients with SLE over five years, patients without MRI abnormalities in the femoral head during the first year of follow-up were less likely to develop osteonecrosis later in li.
Glucocorticoid dose and duration of treatment appear to be important factors in the development of osteonecrosis, although this issue is somewhat controversi.
Other risk factors for osteonecrosis have also been proposed, such as Raynaud's phenomenon and hyperlipidem.
Another study found that the presence of arthritis, glucocorticoid use and/or cytotoxic drugs were associated with a significantly increased risk of osteonecrosis, but antiphospholipid antibodies were not a risk factor for this disea.
Another study found that the presence of arthritis, glucocorticoid use and/or cytotoxic drugs were associated with a significantly increased risk of osteonecrosis, but antiphospholipid antibodies were not a risk factor for this disea.
But antiphospholipid antibodies are not a risk factor for the disea.
Aspect 04
Treatment of osteonecrosis
Treatment of osteonecrosisThere is currently no unified plan for the treatment of osteonecros.
The key to successful treatment of osteonecrosis is early detection and selection of conservative non-surgical treatment or aggressive surgery based on the clinical symptoms and pathological grading of the disea.
The key to successful treatment of osteonecrosis is early detection and selection of conservative non-surgical treatment or aggressive surgery based on the clinical symptoms and pathological grading of the disea.
In patients with lupus, avoid high-dose corticosteroids during the initial period of treatme.
Once the disease has progressed, it may not be diagnosed until after the fracture has occurred, which may require joint arthroplasty (replacemen.
Once the disease has progressed, it may not be diagnosed until after the fracture has occurred, which may require joint arthroplasty (replacemen.
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