The dreaded osteonecrosis of femur following chronic steroid therapy: a case series from a dermatologist’s eye
DOI:
https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20200609Keywords:
Avascular necrosis of femur, Osteopenia, Chronic steroid usage, DEXA scanAbstract
Corticosteroids, undoubtedly, is the saving grace of many patients ailing from a variety of inflammatory and autoimmune dermatoses. But it is not free of side effects, some being crippling enough to subject the patient to huge amounts of morbidity. Here we report a series of cases – Vesiculobullous diseases and Lupus Erythematosus - with prolonged oral steroid therapy that lead to osteopenia and osteonecrosis of the femur.
References
Banks HH. Factors influencing the result in fractures of the femoral neck. J Bone Joint Surg Am. 1962;44:931.
Smith FB. Effects of rotary and valgus malposition on the blood supply to femoral head. J Bone Joint Surg Am. 1959;41:800.
Garden RS. Low angle fixation in the fractures of the femoral neck. J Bone Joint Surg. 1961;313:647.
Brav EA. Traumatic dislocation of the hip: Army experience and results over a twelve year period. J Bone Joint Surg Am. 1962;44:1115.
Lowe HG. Avascular necrosis after slipping of the upper femoral epiphysis. J Bone Joint Surg Br. 1961;43:688.
Herndon JH, Autranc OE. Avascular necrosis of the femoral head in the adult: A review of its incidence in a variety of conditions. Clin Orthop Relat Res. 1972;86:43-62.
Bergstein JM, Wiens C, Fish AJ, Veinier RL, Michael A. Avascular necrosis of bone in systemic lupus erythematosus. J Pediatr. 1974;85:31-5.
Compston J. Glucocorticoid-induced osteoporosis: an update. Endocrine. 2018;61(1):7-16.
van Staa TP, Leufkens HG, Abenhaim L, Begaud S, Zhang B, Cooper C. Use of oral corticosteroids in the United Kingdom. Q Med J. 2000;93:105-11.
Fardet L, Petersen I, Nazareth I. Prevalence of long-term oral glucocorticoid prescriptions in the UK over the past 20 years. Rheumatology. 2011;50(11):1982-90.
Epstien NN, Tuffanelli DL, Epstein JH. Avascular bone necrosis: A complication of long terms corticosteroid therapy. Arch Dermatol. 1965;92:170-80.
Shim SS, Hawk HE, Yu WY. The relationship between blood flow and cavity pressure of bone. Surg Gynaecol Obstet. 1972;135:353-60.
Zizic TM, Hungerford DS, Stevens HB. Ischaemic bone necrosis in systemic lupus erythematosus: 1, The early diagnosis of ischaemic necrosis of bone. Medicine. 1980;59:134-42.
Felson DT, Anderson JJ. A cross study evaluation of association between steroid dose and bolus steroids and vascular necrosis and avascular necrosis of the bone. Lancet. 1987;1:902-6.
Manolagas SC, Weinstein RS. New developments in the pathogenesis and treatment of steroid induced osteoporosis. J Bone Miner Res. 1999;14:1061-6.