The use of joint-specific and whole-body MRI in osteonecrosis: a study in patients with juvenile systemic lupus erythematosus

The use of joint-specific and whole-body MRI in osteonecrosis: a study in patients with juvenile systemic lupus erythematosus

Author Castro, Tania Caroline Monteiro de Autor UNIFESP Google Scholar
Lederman, Henrique Manoel Autor UNIFESP Google Scholar
Terreri, Maria Teresa Ramos Ascensão Autor UNIFESP Google Scholar
Caldana, Wanda Chiyoko Iwakami Autor UNIFESP Google Scholar
Kaste, S. C. Google Scholar
Hilario, M. O. Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Univ Tennessee
Abstract Objective: This study aimed to estimate the prevalence of osteonecrosis (ON) in juvenile systemic lupus erythematosus (SLE) patients using joint-specific and whole-body MRI; to explore risk factors that are associated with the development of ON; and to evaluate prospectively patients 1 year after initial imaging.Method: Within a 2 year period, we studied 40 juvenile SLE patients (aged 8-18 years) with a history of steroid use of more than 3 months duration. Risk factors including disease activity, corticosteroid use, vasculitis, Raynaud's phenomenon and lipid profile were evaluated. All patients underwent MRI of the hips, knees and ankles using joint-specific MRI. Whole-body STIR (short tau inversion recovery) MRI was performed in all patients with ON lesions.Results: Osteonecrosis was identified in 7 patients (17.5 %) upon joint-specific MRI. Whole-body STIR MRI detected ON in 6 of these 7 patients. There was no significant difference between the ON and non-ON groups in the risk factors studied. One patient had pre-existing symptomatic ON. At 1 year follow-up, the ON lesions had resolved in one patient, remained stable in four and decreased in size in two. No asymptomatic patients with ON developed clinical manifestations.Conclusion: Whole-body STIR MRI may be useful in detecting ON lesions in juvenile SLE patients but larger studies are needed to define its role.
Language English
Sponsor Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
Grant number FAPESP: 06/56121-7
Date 2011-07-01
Published in British Journal of Radiology. London: British Inst Radiology, v. 84, n. 1003, p. 621-628, 2011.
ISSN 0007-1285 (Sherpa/Romeo, impact factor)
Publisher British Inst Radiology
Extent 621-628
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000291928700011

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