{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T10:59:39Z","timestamp":1790420379327,"version":"4.1.0"},"reference-count":18,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2022,1,5]],"date-time":"2022-01-05T00:00:00Z","timestamp":1641340800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int Forum Allergy Rhinol"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>The risk of adverse events, specifically avascular necrosis (AVN), associated with corticosteroid use is not well reported. The aim of this study was to evaluate the prevalence of AVN among patients with prior oral corticosteroid administration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>An institutional database query recognized 113,734 adult patients with oral corticosteroid administration between January 2006 and May 2017. A temporal query performed on this cohort determined that 789 had a diagnosis of AVN following oral corticosteroids. A retrospective review was performed on this cohort. Data collected included demographics, comorbidities, date of initial oral corticosteroid exposure, and time to diagnosis of AVN. Records without radiographic confirmation of AVN were excluded from analysis. Patients with cumulative lifetime dosages greater than 10,000\u00a0mg prednisone were excluded from analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 789 patients with oral corticosteroid use prior to diagnosis of AVN were identified. Five hundred and seventy\u2010two patients were excluded due to insufficient documentation of oral corticosteroid dosage, no radiographic evidence supporting the diagnosis of AVN, insufficient data confirming the temporal relationship between oral corticosteroids and AVN, and\/or a cumulative dosing of\u00a0&gt;10,000\u00a0mg prednisone. This left 217 patients included in the analysis. The mean duration of use prior to diagnosis of AVN was 219\u00a0(\u00b1\u00a0374) days, and mean cumulative dose was 3314\u00a0(\u00b1\u00a02908)\u00a0mg prednisone equivalents. Mean time between diagnosis of AVN and onset of pathologic fracture was 379\u00a0(\u00b1\u00a01046)\u00a0days.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>For patients receiving low cumulative doses of oral corticosteroids, corticosteroids pose a small risk of development of AVN. More studies are required to better characterize risk.<\/jats:p><\/jats:sec>","DOI":"10.1002\/alr.22950","type":"journal-article","created":{"date-parts":[[2021,12,17]],"date-time":"2021-12-17T07:23:01Z","timestamp":1639725781000},"page":"903-909","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Oral corticosteroid use and the risk of developing avascular necrosis: A large retrospective review"],"prefix":"10.1002","volume":"12","author":[{"given":"Sarah E","family":"Grond","sequence":"first","affiliation":[{"name":"Division of Rhinology and Skull Base Surgery, Department of Otolaryngology and Communication Sciences Medical College of Wisconsin  Milwaukee Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4000-946X","authenticated-orcid":false,"given":"Ryan E","family":"Little","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology\u2010Head and Neck Surgery, Department of Surgery, Geisel School of Medicine at Dartmouth  Lebanon New Hampshire USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David A","family":"Campbell","sequence":"additional","affiliation":[{"name":"Division of Rhinology and Skull Base Surgery, Department of Otolaryngology and Communication Sciences Medical College of Wisconsin  Milwaukee Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Todd A","family":"Loehrl","sequence":"additional","affiliation":[{"name":"Division of Rhinology and Skull Base Surgery, Department of Otolaryngology and Communication Sciences Medical College of Wisconsin  Milwaukee Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David M","family":"Poetker","sequence":"additional","affiliation":[{"name":"Division of Rhinology and Skull Base Surgery, Department of Otolaryngology and Communication Sciences Medical College of Wisconsin  Milwaukee Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,1,5]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/014556139607500809"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLG.0b013e31817c0b4d"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.2500\/ajr.2007.21.3047"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.22741"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.29495"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21072"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2010.04.003"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/39.12.1383"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.3109\/02770909909065152"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199205283262206"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2010.06.007"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.j1415"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-2197.2005.03389.x"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.2500\/ar.2016.7.0142"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOO.0000000000000421"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/0145561319876906"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.5312\/wjo.v6.i8.590"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1053\/sarh.2002.33724b"}],"container-title":["International Forum of Allergy &amp; 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