Ratcliffe M A, Gilbert F J, Dawson A A, Bennett B
Aberdeen Royal Infirmary.
Hematol Oncol. 1995 May-Jun;13(3):131-7. doi: 10.1002/hon.2900130303.
Avascular necrosis of bone (AVNB) is a well-known but rare complication of chemotherapy for lymphoma with a reported incidence ranging from 1 to 10 per cent. Early diagnosis is essential for optimal therapeutic management. Using MRI, the most sensitive means of detecting the earlier stages of AVNB, 100 patients treated with standard chemotherapy for lymphoma were assessed. Fifteen were found to have changes of AVNB, 10 with early changes but five with advanced segmental collapse of the femoral head. None with AVNB had more than the standard course of corticosteroids. Almost a quarter of the study group complained of joint pain during and/or after their treatment, a third of whom were found to have AVNB; a strong indicator to screen all those with pain. However, 40 per cent of those with AVNB were asymptomatic. The clinical significance of the 'silent hip' is yet to be elucidated.
骨缺血性坏死（AVNB）是淋巴瘤化疗一种众所周知但罕见的并发症，报道的发病率在1%至10%之间。早期诊断对于最佳治疗管理至关重要。使用磁共振成像（MRI）这种检测AVNB早期阶段最敏感的方法，对100例接受淋巴瘤标准化疗的患者进行了评估。发现15例有AVNB改变，10例有早期改变，但5例有股骨头晚期节段性塌陷。有AVNB的患者均未使用超过标准疗程的皮质类固醇。几乎四分之一的研究组患者在治疗期间和/或治疗后抱怨关节疼痛，其中三分之一被发现有AVNB；这是筛查所有疼痛患者的一个有力指标。然而，40%有AVNB的患者无症状。“静息性髋关节”的临床意义尚待阐明。
