{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T10:55:15Z","timestamp":1791111315881,"version":"4.1.0"},"reference-count":19,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2018,9,5]],"date-time":"2018-09-05T00:00:00Z","timestamp":1536105600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100012524","name":"American Lebanese Syrian Associated Charities","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012524","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2018,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Avascular necrosis (AVN) is a chronic bone complication of sickle cell disease (SCD) resulting in significant morbidity. Understanding associated risk factors can facilitate risk\u2010based screening, earlier identification, and prompt intervention. Between 1998 and 2014, 26 symptomatic cases with imaging evidence of AVN were compared 1:5 with age\u2010 and SCD genotype\u2010matched controls (<jats:italic>n<\/jats:italic>\u00a0=\u00a0128). Patients with 1\u20135 vaso\u2010occlusive crisis (VOC) (OR 11.9, 95% CI, 1.4\u201399.9; <jats:italic>P\u00a0<\/jats:italic>=\u00a00.02) and more than 5 VOC (OR 53.6, 95% CI, 5.5\u2013520.2; <jats:italic>P\u00a0<\/jats:italic>=\u00a00.0006) in a 5\u2010year period were more likely to have AVN. Symptomatic patients with more than five VOC in 5 years may benefit from radiologic screening for AVN.<\/jats:p>","DOI":"10.1002\/pbc.27435","type":"journal-article","created":{"date-parts":[[2018,9,5]],"date-time":"2018-09-05T10:12:52Z","timestamp":1536142372000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Vaso\u2010occlusive crisis as a predictor of symptomatic avascular necrosis in children with sickle cell disease"],"prefix":"10.1002","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7846-2326","authenticated-orcid":false,"given":"Akram","family":"Mesleh Shayeb","sequence":"first","affiliation":[{"name":"Departments of Hematology St. Jude Children's Research Hospital  Memphis Tennessee"},{"name":"Departments of Pediatrics University of Tennessee Health Science Center  Memphis Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew P.","family":"Smeltzer","sequence":"additional","affiliation":[{"name":"Division of Epidemiology, Biostatistics, and Environmental Health The University of Memphis School of Public Health  Memphis Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sue C.","family":"Kaste","sequence":"additional","affiliation":[{"name":"Diagnostic Imaging and Oncology St. Jude Children's Research Hospital  Memphis Tennessee"},{"name":"Radiology, University of Tennessee Health Science Center  Memphis Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley","family":"Brown","sequence":"additional","affiliation":[{"name":"University of Mississippi Medical Center  Jackson Mississippi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremie H.","family":"Estepp","sequence":"additional","affiliation":[{"name":"Departments of Hematology St. Jude Children's Research Hospital  Memphis Tennessee"},{"name":"Departments of Pediatrics University of Tennessee Health Science Center  Memphis Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerri A.","family":"Nottage","sequence":"additional","affiliation":[{"name":"Janssen Research &amp; 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