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Relationship between systemic corticosteroids and osteonecrosis.

K L Gebhard1, H I Maibach

  • 1Department of Dermatology, School of Medicine, University of California, San Francisco, USA.

American Journal of Clinical Dermatology
|January 5, 2002
PubMed
Summary
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Oral corticosteroid therapy may increase the risk of osteonecrosis, particularly of the femoral head. While a direct link remains uncertain, evidence suggests a cause-and-effect relationship, necessitating further research and patient awareness.

Area of Science:

  • Dermatology
  • Orthopedics
  • Pharmacology

Background:

  • Osteonecrosis, especially of the femoral head, is a known complication of oral corticosteroid therapy.
  • The exact contribution of corticosteroids versus other factors in developing osteonecrosis is debated.
  • Oral corticosteroids are widely used in dermatology for various inflammatory and autoimmune conditions.

Purpose of the Study:

  • To review the relationship between oral corticosteroid treatment and the onset of femoral head osteonecrosis.
  • To evaluate the current evidence and controversies surrounding corticosteroid-induced osteonecrosis.
  • To inform dermatologists about the potential risks and necessary patient counseling.

Main Methods:

  • Literature review of clinical and experimental data.

Related Experiment Videos

  • Focus on osteonecrosis of the femoral head as the primary site of interest.
  • Discussion of diagnostic methods like MRI and management strategies.

    • Main Results:

    • Corticosteroid treatment is indicated as the most common cause of femoral head osteonecrosis, despite other potential causes.
    • Controversy exists regarding the influence of the underlying disease and cumulative corticosteroid dose.
    • The overall risk of osteonecrosis with oral corticosteroids is generally considered low, but a causal relationship is strongly suggested.

    Conclusions:

    • A definitive causal link between oral corticosteroids and femoral head osteonecrosis requires further investigation, including large prospective studies.
    • Dermatologists must remain aware of this severe potential complication and counsel patients accordingly.
    • Early diagnosis through MRI and tailored management are crucial for affected patients.