Silent osteonecrosis of the femoral head following high-dose corticosteroids in patients with systemic rheumatic diseases

Kianmehr, Nahid; Bidari, Ali; Mofidi, Mani; Bahar, Nasim

The ethical aspects of the study were approved by the university review committee and informed consent was obtained from all of the patients prior to their participation in the study. A structured checklist was used to collect data on demographic variables, dose and duration of CS therapy, and route of CS administration. Complete blood count, lipid panel, anti-phospholipid antibodies and hypercoagulable profile were measured in all cases. Femoral heads were targeted for ON screening purposes as they comprise the most frequent sites for CSinduced ON. All MRI studies were performed by a single 1.5 Tesla imaging scanner and reported independently by two MRI expert radiologists and by a third one in case of disagreement. ON was defined as the presence of band of low signal intensity in classic T1 and T2weighted images in any portion of femoral head. However, the radiologists were asked to report any other abnormal signal intensities.