Arthropathy Associated with Steroid Therapy

Article1 April 1966Arthropathy Associated with Steroid TherapyEDWARD E. VELAYOS, M.D., JOHN D. LEIDHOLT, M.D., CHARLEY J. SMYTH, M.D., F.A.C.P., ROBERT PRIEST, M.D.EDWARD E. VELAYOS, M.D.Search for more papers by this author, JOHN D. LEIDHOLT, M.D.Search for more papers by this author, CHARLEY J. SMYTH, M.D., F.A.C.P.Search for more papers by this author, ROBERT PRIEST, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-64-4-759 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptPhysicians experienced in the use of steroid therapy now generally recognize that patients treated with intensive systemic corticosteroids may develop osteoporosis and spontaneous vertebral fractures. They report with increasing frequency another skeletal complication of prolonged oral steroid therapy, the development of "avascular necrosis of bone" (1-9). The report of Sutton, Benedek, and Edwards (10) in 1963 includes a comprehensive review of the 62 published cases of "aseptic necrosis" occurring in association with the administration of cortisone. Some authors consider that repeated intra-articular steroid injections result in accelerated joint destruction (2, 11-14). The opposite opinion has been expressed by Isdale (15)...References1. DUBOISCOZEN ELL: Avascular (aseptic) bone necrosis associated with systemic lupus erythematosus. JAMA 174: 966, 1960. CrossrefMedlineGoogle Scholar2. SWEETNAMMASONMURRAY DRRMRO: Steroid arthropathy of the hip. Brit. Med. J. 1: 1392, 1960. CrossrefMedlineGoogle Scholar3. EDSTROM G: Destructions of hip joint in rheumatoid arthritis during long-term steroid therapy. Acta Rheum. Scand. 7: 151, 1961. CrossrefMedlineGoogle Scholar4. HARNAGEL EE: Prolonged steroid therapy and accelerated joint destruction. Amer. Pract. 13: 480, 1962. Google Scholar5. MURRAY RO: Steroids and the skeleton. Radiology 77: 729, 1961. CrossrefMedlineGoogle Scholar6. PAUL WD: Systemic manifestations of rheumatoid arthritis (rheumatoid disease) accentuated by steroid therapy. J. Iowa Med. Soc. 51: 205, 1961. MedlineGoogle Scholar7. PIETROGRANDIMASTROMARINO VR: Osteopatia da prolugato trattamento cortisonico. Ortop. Traum. Appar. Mot. 25: 791, 1957. Google Scholar8. MURRAY RO: Radiological bone changes in Cushing's syndrome and steroid therapy. Brit. J. Radiol. 33: 1, 1960. CrossrefMedlineGoogle Scholar9. MEYERGOLTERHAWLEY TLEC: Avascular necrosis of bone following systemic steroid therapy. Radiology 80: 422, 1963. CrossrefMedlineGoogle Scholar10. SUTTONBENEDEKEDWARDS RDTGGA: Aseptic bone necrosis and corticosteroid therapy. Arch. Intern. Med. (Chicago) 112: 594, 1963. CrossrefMedlineGoogle Scholar11. CHANDLERWRIGHT GNV: Deleterious effect of intra-articular hydrocortisone. Lancet 2: 661, 1958. CrossrefMedlineGoogle Scholar12. CHANDLERJONESWRIGHTHARTFALL GNDTVSL: Charcot's arthropathy following intra-articular hydrocortisone. Brit. J. Med. 1: 952, 1959. CrossrefMedlineGoogle Scholar13. SWEETNAM R: Cortisone arthropathy of hip. Proc. Roy. Soc. Med. 53: 63, 1960. CrossrefMedlineGoogle Scholar14. STEINBERGDUTHIEPIVA CLRBAE: Charcot-like arthropathy following intra-articular hydrocortisone. JAMA 181: 851, 1962. CrossrefMedlineGoogle Scholar15. ISDALE IC: Femoral head destruction in rheumatoid arthritis and osteo-arthritis. A clinical review of 27 cases. Ann. Rheum. Dis. 21: 23, 1962. CrossrefMedlineGoogle Scholar16. MOYNIHAN FJ: Cortisone arthropathy. Guy Hosp. Rep. 111: 388, 1962. MedlineGoogle Scholar17. KENDALL PH: Untoward effects following local hydrocortisone injection. Ann. Phys. Med. 4: 170, 1958. MedlineGoogle Scholar18. STEINBROCKERTRAEGERBATTERMAN OCHRC: Therapeutic criteria in rheumatoid arthritis. JAMA 140: 659, 1949. CrossrefMedlineGoogle Scholar19. HEIMANNFREIBERGER WGRH: Avascular necrosis of the femoral and humeral heads after high-dosage corticosteroid therapy. New Eng. J. Med. 263: 672, 1960. CrossrefMedlineGoogle Scholar20. WERNE S: Compression fracture of the femoral head in association with cortisone therapy. Acta Orthop. Scand. 32: 413, 1962. CrossrefMedlineGoogle Scholar21. JOHNSONSMYTHHOLTLUBCHENCOVALENTINE RLCJGWAE: Steroid therapy and vascular lesions in rheumatoid arthritis. Arthritis Rheum. 2: 224, 1959. CrossrefMedlineGoogle Scholar22. KEMPERBAGGENSTOSSSLOCUMB JWAHCH: The relationship of therapy with cortisone to the incidence of vascular lesions in rheumatoid arthritis. Ann. Intern. Med. 46: 831, 1957. LinkGoogle Scholar23. RUDERMANMCCARTY MDJ: Aseptic necrosis in systemic lupus erythematosus—report of a case involving six joints. Arthritis Rheum. 7: 709, 1964. CrossrefMedlineGoogle Scholar24. SIEMSENBROOKMEISTER JKJL: Lupus erythematosus and avascular bone necrosis: a clinical study of three cases and review of the literature. Arthritis Rheum. 5: 492, 1962. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Denver, ColoradoFrom the Departments of Internal Medicine, Pathology and the Division of Orthopedic Surgery, University of Colorado School of Medicine, Denver, Colo.This study was presented in part at the Golden Anniversary Session of the American College of Physicians, March 25, 1965.Requests for reprints should be addressed to Charley J. Smyth, M.D., University of Colorado Medical Center, 4200 East 9th Ave., Denver, Colo. 80220. 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SWEET Jr., M.D., DANIEL G. ROTH, M.D., RICHARD K. DESSER, M.D., J. BRUCE MILLER, M.D., JOHN E. ULTMANN, M.D., F.A.C.P.Zirkulatorische KnochenveränderungenFemoral Head Necrosis in Renal Transplanted Patients. Evidence of a Haemodynamic Etiological FactorAseptic necrosis of bone in systemic lupus erythematosusAvascular necrosis of bone in systemic lupus erythematosusCorticosteroid Therapy for Rheumatoid ArthritisCushing's syndrome and avascular necrosis of bone associated with carcinoid-islet cell tumor of the pancreasNeuropathic jointsPeriostitis, Aseptic Necrosis, and Arthritis Occurring in a Patient with Crohn's DiseaseAdrenal glucocorticoids after twenty yearsBone Necrosis in Joint Disease 1 April 1966Volume 64, Issue 4Page: 759-771KeywordsArthritisHipImmunosuppressivesNecrosisOral administrationOrthopedic surgeryOsteoporosisRenal transplantationSteroid therapyVasculitis Issue Published: 1 April 1966 PDF DownloadLoading ...