{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T17:34:56Z","timestamp":1786988096569,"version":"build-2736575974"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","license":[{"start":{"date-parts":[[2020,8,1]],"date-time":"2020-08-01T00:00:00Z","timestamp":1596240000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Osteonecrosis or Avascular necrosis of bone (AVN) is a well recognized complication of systemic lupus erythematosus (SLE) leading to significant morbidity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We did a cross sectional descriptive study in cohort of SLE patients, on regular follow-up at our Rheumatology OPD over a period of 5 years from 2012 to 2017.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Of the total 415 SLE, 5.1% (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 21) patients were diagnosed to have osteonecrosis. The mean age was 32.8 \u00b1 7.6 years. Male: female were 1:4.2. Mean time interval between the onset of SLE and diagnosis of osteonecrosis was 4.1 \u00b1 2.7 years. Pain (100%) was the most common presenting symptom followed by limping gait (42.8%). Most common site affected by osteonecrosis was femoral head (80.9%) (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 17). 14.3% (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 3) had multifocal involvement. The most common systemic involvement was musculoskeletal system (80.9%). In total 28.5% had secondary antiphospholipid syndrome. Mean SLEDAI-2K at the time of diagnosis of osteonecrosis was 5.3 \u00b1 2.9. Hypertension 19%, hypothyroidism 9.5%, osteoporosis 24%, and chronic HCV infection 4.7% were the associated comorbidities. The most common stage by imaging at diagnosis was stage IV (38%), followed by 24% stage V, 19% stage III and 9.5% stage II and 9.5% stage VI. Medical management include bisphosphonates (100%), statins (90.4%) and anticoagulant therapy (28.5%), while 9.5% received core decompression surgery and 14.3% underwent total hip replacement. The mean daily dose of prednisolone at diagnosis of osteonecrosis was 8.5mg (range 5\u201320mg).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>This study described the prevalence and epidemiology of osteonecrosis in our cohort of SLE patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jfmpc.jfmpc_1234_19","type":"journal-article","created":{"date-parts":[[2020,9,1]],"date-time":"2020-09-01T05:57:47Z","timestamp":1598939867000},"page":"4363-4367","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":10,"title":["Clinical profile of osteonecrosis in systemic lupus erythematosus \u2013 Experience from a tertiary care centre in South India"],"prefix":"10.4103","volume":"9","author":[{"given":"Saranya","family":"Chinnadurai","sequence":"first","affiliation":[{"name":"Department of Rheumatology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India"},{"name":"Department of Rheumatology, Madras Medical College and RGGGH, Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Balaji","family":"Chilukuri","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India"},{"name":"Department of Rheumatology, Madras Medical College and RGGGH, Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bhuvanesh","family":"Mahendran","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Madras Medical College and RGGGH, Chennai, Tamil Nadu, India"},{"name":"Department of Rheumatology, KIMS, Thiruvananthapuram, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vignesh","family":"Mantharam","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India"},{"name":"Department of Rheumatology, Madras Medical College and RGGGH, Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Balameena","family":"Selvakumar","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Madras Medical College and RGGGH, Chennai, Tamil Nadu, India"},{"name":"Department of Rheumatology, Kilpauk Medical College, Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajeswari","family":"Sankaralingam","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India"},{"name":"Department of Rheumatology, Madras Medical College and RGGGH, Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020,8]]},"reference":[{"key":"R4-20260817","first-page":"700","article-title":"A meta-analysis of avascular necrosis in systemic lupus erythematosus: Prevalence and risk factors","volume":"35","author":"Nevskaya","year":"2017","journal-title":"ClinExpRheumatol"},{"key":"R5-20260817","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1302\/0301-620X.77B1.7822393","article-title":"A quantitative system for staging avascular necrosis","volume":"77","author":"Steinberg","year":"1995","journal-title":"J Bone Joint Surg Br"},{"key":"R6-20260817","first-page":"288","article-title":"Systemic lupus erythematosus disease activity index 2000","volume":"29","author":"Gladman","year":"2002","journal-title":"J Rheumatol"},{"issue":"Suppl 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