The Open Arthritis Journal
2010, 3 : 47-52Published online 2010 September 08. DOI: 10.2174/1876539401003010047
Publisher ID: TOARTHJ-3-47
RESEARCH ARTICLE
Systemic Lupus Erythematosus and Osteonecrosis: A Comparison of
Patients with Single versus Multiple Joint Involvement
2 Division of Biostatistics, Department of Health Sciences Research, Mayo Clinic, USA
3 Department of Radiology, Mayo Clinic, USA
4 Department of Orthopedic Surgery, Mayo Clinic, USA
* Address correspondence to these authors at the Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA; Tel: 507-284-2975; Fax: 507-284- 0564; E-mail: Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA; Tel: 507- 284-1625; Fax: 507-284-0564; E-mail: kermani.tanaz@mayo.edu
ABSTRACT
Objective:
The purpose of this study was to determine the clinical and laboratory features associated with osteonecrosis of multiple (>/= 3) joints in systemic lupus erythematosus (SLE).
Methods:
We included all patients with SLE and osteonecrosis evaluated at our institution between January 1, 2000 and June 30, 2006. The patients were divided into three groups based on osteonecrosis of 1 joint, 2 joints and 3 or more joints. Clinical features, laboratory findings and therapies of patients in these groups were compared using Fischer’s exact test and rank sum tests.
Results:
Our study included 4 men and 37 women. Twelve patients (29.3%) had osteonecrosis of 1 joint, 16 patients (39%) had osteonecrosis of 2 joints and 13 patients (31.7%) had osteonecrosis of 3 or more joints. The only clinical feature of SLE significantly associated with osteonecrosis of 3 or more joints was central nervous system (CNS) disease (p = 0.01). The median cumulative and peak corticosteroid doses were similar in all 3 groups (p = 0.70 and p = 0.11 respectively). There were no differences in the frequency of anti-cardiolipin antibodies.
Conclusions:
History of CNS disease was the only variable associated with multiple joint osteonecrosis in patients with SLE. We found no association between corticosteroid doses and multiple joint osteonecrosis.