Ibad Hamza A, Ghotbi Elena, Kasaeian Arta, Levin Adam S, Jones Lynne C, Anzai Yoshimi, Soltanolkotabi Maryam, Kapoor Neena, Johnson Pamela T, Demehri Shadpour
The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
Department of Orthopedic Surgery, The Johns Hopkins University, Baltimore, MD 21287, USA.
Diagnostics (Basel). 2024 Jan 27;14(3):279. doi: 10.3390/diagnostics14030279.
. This paper aims to estimate asymptomatic hip osteonecrosis prevalence in SLE patients using MRI examination and to determine the prevalence among higher risk subpopulations. . PubMed, Embase, Cochrane, and SCOPUS were searched from inception to May 9th, 2023. Studies on patients who were clinically diagnosed with systemic lupus erythematosus without reported symptoms attributable to hip osteonecrosis were included. Two independent reviewers extracted data and assessed the risk of bias. Data collected from each study include the study year, the number of hips screened, the number of hips with osteonecrosis, demographics, laboratory data, medications, follow-up time, radiological protocols, and MRI-based osteonecrosis detection and grading criteria. . Eleven eligible studies including 503 participants (15-35 years old; 74-100% female) with SLE were identified. Significant risk of bias was determined in one study. The overall prevalence of osteonecrosis of the hip was found to be 14% (184/1006 hip joints, 95% confidence interval: 7-22%, number needed to scan: 7.1). SLE patients who received corticosteroid treatment had a higher prevalence of asymptomatic hip osteonecrosis (18%) compared to non-corticosteroid users (0%, -value < 0.01). Additionally, meta-regression results revealed that daily corticosteroid dose was associated with increased prevalence of asymptomatic osteonecrosis (0.5%/milligram, -value < 0.01). . The high prevalence of asymptomatic hip osteonecrosis in SLE patients raises concerns about the timeliness of interventions. The limitations of this study include a relatively low number of identified studies; and one study lacked full-text availability.
本文旨在通过MRI检查评估系统性红斑狼疮（SLE）患者无症状性髋部骨坏死的患病率，并确定高危亚人群中的患病率。从数据库建库至2023年5月9日检索了PubMed、Embase、Cochrane和SCOPUS。纳入临床诊断为系统性红斑狼疮且无髋部骨坏死相关症状报告的患者的研究。两名独立评审员提取数据并评估偏倚风险。从每项研究中收集的数据包括研究年份、筛查的髋部数量、患有骨坏死的髋部数量、人口统计学、实验室数据、用药情况、随访时间、放射学检查方案以及基于MRI的骨坏死检测和分级标准。确定了11项符合条件的研究，包括503名（15 - 35岁；女性占74 - 100%）SLE患者。一项研究存在显著偏倚风险。发现髋部骨坏死的总体患病率为14%（184/1006个髋关节，95%置信区间：7 - 22%，需要扫描的数量：7.1）。接受皮质类固醇治疗的SLE患者无症状性髋部骨坏死的患病率（18%）高于未使用皮质类固醇的患者（0%，P值<0.01）。此外，meta回归结果显示每日皮质类固醇剂量与无症状性骨坏死患病率增加相关（0.5%/毫克，P值<0.01）。SLE患者无症状性髋部骨坏死的高患病率引发了对干预及时性的担忧。本研究的局限性包括纳入研究数量相对较少；一项研究缺乏全文。
