Royal Bolton Hospital, Bolton, UK.
Mult Scler. 2010 Mar;16(3):370-2. doi: 10.1177/1352458509358091. Epub 2010 Jan 19.
There is a well-established link between the development of osteonecrosis and steroid administration. Diaphyseal osteonecrosis is rare and, when present, frequently asymptomatic and detected radiologically. We present a case of symptomatic, multifocal, diaphyseal osteonecrosis in a woman receiving pulsed corticosteroids for symptom control of multiple sclerosis (MS). She was investigated for knee pain, which could have been attributed to her primary disease, and magnetic resonance imaging (MRI) revealed bone infarcts within the femur, tibia and talus. She underwent successful intra-medullary reaming to the diaphyseal infarcts. This case highlights the importance of investigating musculoskeletal pain in patients with MS, receiving corticosteroids.
骨坏死的发展与类固醇的应用之间存在明确的关联。骨干骨坏死较为罕见，而且即使发生，通常也没有症状，仅通过影像学检测发现。我们报告了一例多发性硬化症（MS）女性患者在接受脉冲皮质类固醇治疗以控制症状时发生的症状性、多灶性、骨干骨坏死。该患者因膝关节疼痛就诊，而这种疼痛可能与她的原发性疾病有关，磁共振成像（MRI）显示股骨、胫骨和距骨内存在骨梗死。她成功地接受了骨干梗死的髓内扩孔治疗。该病例强调了对接受皮质类固醇治疗的 MS 患者进行肌肉骨骼疼痛调查的重要性。
