Rai Paul, Takwale Vinay
Cheltenham General Hospital, Sandford Road, Cheltenham, Gloucestershire GL53 7AN, UK.
Gloucestershire NHS Trust, UK.
Case Rep Rheumatol. 2014;2014:515361. doi: 10.1155/2014/515361. Epub 2014 Apr 6.
Avascular necrosis (AVN) of the scaphoid secondary to corticosteroid use is a rare entity. Previous reports in the literature refer to chronic steroid intake. We report a case secondary to low dose, short term use. AVN has a multifactorial cellular and genetic aetiology and most frequently affects the femoral head. Diagnosis relies on a high index of suspicion and early magnetic resonance (MR) scanning. Treatment options are similar to those of traumatic scaphoid nonunions and include vascularised bone grafting and scaphoid excision. Polymyalgia Rheumatica is a common condition and its treatment is led by corticosteroid use. Mild to moderate strengths are advocated. However in our report we show that even with small doses serious adverse effects can be encountered.
因使用皮质类固醇继发舟状骨缺血性坏死（AVN）是一种罕见情况。文献中既往报道均涉及长期服用类固醇。我们报告一例因低剂量、短期使用类固醇继发的病例。AVN具有多因素的细胞和遗传病因，最常累及股骨头。诊断依赖于高度的怀疑指数和早期磁共振（MR）扫描。治疗选择与创伤性舟状骨不愈合相似，包括带血管蒂骨移植和舟状骨切除。风湿性多肌痛是一种常见病症，其治疗以使用皮质类固醇为主。提倡使用轻度至中度强度的药物。然而在我们的报告中，我们表明即使是小剂量也可能会出现严重的不良反应。
