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Related Experiment Video

Updated: Mar 2, 2026

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Osteonecrosis in SLE: prevalence, patterns, outcomes and predictors.

D D Gladman1, N Dhillon1, J Su1

  • 1University of Toronto Lupus Clinic, Toronto Western Hospital, Toronto, Canada.

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|May 23, 2017
PubMed
Summary

Symptomatic osteonecrosis affects 13.5% of systemic lupus erythematosus patients, commonly impacting hips and knees. Glucocorticosteroids are the primary predictor, highlighting the need to minimize their use to prevent this complication.

Keywords:
Systemic lupus erythematosusosteonecrosisoutcomespredictive factors

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Area of Science:

  • Rheumatology
  • Orthopedics
  • Internal Medicine

Background:

  • Osteonecrosis is a significant complication in systemic lupus erythematosus (SLE) patients.
  • Understanding its prevalence, patterns, and predictors is crucial for patient management.

Purpose of the Study:

  • To determine the prevalence, joint involvement patterns, and outcomes of symptomatic osteonecrosis in a large SLE cohort.
  • To identify predictive factors for osteonecrosis development in SLE patients.

Main Methods:

  • Prospective follow-up of SLE patients at the Toronto Lupus Clinic since 1970.
  • Longitudinal cohort design for prevalence, pattern, and outcome assessment.
  • Matched case-control analysis for predictive factor identification.

Main Results:

  • 13.5% of 1729 SLE patients developed symptomatic osteonecrosis, affecting 581 sites.
  • Hips and knees were most frequently involved; 47% had multiple sites affected.
  • Glucocorticosteroids were identified as the primary predictor for osteonecrosis development.

Conclusions:

  • Symptomatic osteonecrosis remains a significant comorbidity in SLE despite treatment advancements.
  • Minimizing glucocorticosteroid use is essential for preventing osteonecrosis in SLE patients.