Jeong Hye-Jin, Kim Dam, Cho Soo-Kyung, Kim Yeesuk, Bae Sang-Cheol, Sung Yoon-Kyoung
Department of Rheumatology, Keimyung University Dongsan Medical Center, Daegu, Korea.
Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Korea.
Int J Rheum Dis. 2018 Jun;21(6):1301-1308. doi: 10.1111/1756-185X.13065. Epub 2017 Mar 22.
Osteonecrosis (ON), also known as avascular necrosis, is an important cause of physical disability in rheumatic disease. When this condition affects multiple structures, disability is increased. The purpose of this study was to describe the clinical characteristics of Korean patients with multifocal ON associated with rheumatic disease and to compare them with those of previously reported cases.
We reviewed the clinical characteristics of eight Korean patients with multifocal ON, defined by the involvement of three or more anatomic sites, associated with rheumatic disease in a single referral academic hospital, and compared them with those of 19 similar cases previously reported in the literature.
All eight patients were female, with median age of 26 years. All had underlying systemic lupus erythematosus (SLE) and had been using corticosteroids. The most common site affected by ON was the knee joint. However, in contrast to our patients, the previous reported cases had other rheumatic diseases such as myositis, scleroderma and antiphospholipid syndrome. In comparison between Korean multifocal ON patients with SLE and those of previous reports, shoulder joint involvement was higher in previous reports. Common features in patients from both groups were knee joint involvement and prevalent use of corticosteroids.
Our findings indicate that multifocal ON is common in young SLE patients who have been using corticosteroids and the most commonly involved site is the knee.
骨坏死（ON），也称为缺血性坏死，是风湿性疾病导致身体残疾的重要原因。当这种情况影响多个结构时，残疾程度会增加。本研究的目的是描述韩国风湿性疾病相关多灶性骨坏死患者的临床特征，并将其与先前报道的病例进行比较。
我们回顾了一家转诊学术医院中8例韩国多灶性骨坏死患者的临床特征，这些患者由三个或更多解剖部位受累定义，与风湿性疾病相关，并将其与文献中先前报道的19例类似病例进行比较。
所有8例患者均为女性，中位年龄为26岁。所有患者均患有潜在的系统性红斑狼疮（SLE）且一直在使用皮质类固醇。骨坏死最常累及的部位是膝关节。然而，与我们的患者不同，先前报道的病例患有其他风湿性疾病，如肌炎、硬皮病和抗磷脂综合征。在韩国多灶性骨坏死SLE患者与先前报道的患者之间的比较中，先前报道的患者肩关节受累情况更多。两组患者的共同特征是膝关节受累和普遍使用皮质类固醇。
我们的研究结果表明，多灶性骨坏死在使用皮质类固醇的年轻SLE患者中很常见，最常累及的部位是膝关节。
