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Evidence is conflicting on the relative importance of peak dose, daily dose, or cumulative dose, and most likely all three represent \u201chigh dose\u201d corticosteroid administration and play a role in AVN. The etiology may be multifactorial with corticosteroids superimposed on genetic or pathological predispositions. Joint preservation depends upon early diagnosis and treatment before fracture of the subchondral trabeculae and joint incongruity. Early intervention depends upon identifying at\u2010risk patients and quantifying their risk by understanding clinical and pathophysiological contributions to that risk. Our data and that of others suggest that a screening MRI of at\u2010risk populations will permit detection of AVN at a prefracture stage when preservation of the joint is possible.<\/jats:bold><\/jats:p>","DOI":"10.1111\/j.1749-6632.2011.06218.x","type":"journal-article","created":{"date-parts":[[2011,12,15]],"date-time":"2011-12-15T15:21:51Z","timestamp":1323962511000},"page":"38-46","source":"Crossref","is-referenced-by-count":44,"title":["Corticosteroid\u2010associated avascular necrosis: dose relationships and early diagnosis"],"prefix":"10.1111","volume":"1240","author":[{"given":"Roy K.","family":"Aaron","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Voisinet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Racine","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yousaf","family":"Ali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward R.","family":"Feller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2011,12,15]]},"reference":[{"key":"e_1_2_9_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199205283262206"},{"key":"e_1_2_9_3_2","first-page":"1689","volume-title":"Textbook of Rheumatology","author":"Zizic T.M.","year":"1985"},{"key":"e_1_2_9_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4615-2838-8_27"},{"key":"e_1_2_9_5_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-197052020-00012"},{"key":"e_1_2_9_6_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-198769080-00016"},{"key":"e_1_2_9_7_2","first-page":"51","article-title":"Epidemiology of traumatic and nontraumatic osteonecrosis","volume":"130","author":"Jacobs B.","year":"1978","journal-title":"Clin. 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