The use of joint-specific and whole-body MRI in osteonecrosis: a study in patients with juvenile systemic lupus erythematosus

Objective: This study aimed to estimate the prevalence of osteonecrosis (ON) in juvenile systemic lupus erythematosus (SLE) patients using joint-specific and whole-body MRI; to explore risk factors that are associated with the development of ON; and to evaluate prospectively patients 1 year after in...

Full description

Access type:openAccess
Publication Date:2011
Main Author: Castro, Tania Caroline Monteiro de [UNIFESP]
Other Authors: Lederman, Henrique Manoel [UNIFESP], Terreri, Maria Teresa Ramos Ascensão [UNIFESP], Caldana, Wanda Chiyoko Iwakami [UNIFESP], Kaste, S. C., Hilario, M. O. [UNIFESP]
Document type: Article
Language:eng
Published: British Inst Radiology
Online Access:http://repositorio.unifesp.br/handle/11600/33829
http://dx.doi.org/10.1259/bjr/34972239
Citation:British Journal of Radiology. London: British Inst Radiology, v. 84, n. 1003, p. 621-628, 2011.
English abstract:Objective: This study aimed to estimate the prevalence of osteonecrosis (ON) in juvenile systemic lupus erythematosus (SLE) patients using joint-specific and whole-body MRI; to explore risk factors that are associated with the development of ON; and to evaluate prospectively patients 1 year after initial imaging.Method: Within a 2 year period, we studied 40 juvenile SLE patients (aged 8-18 years) with a history of steroid use of more than 3 months duration. Risk factors including disease activity, corticosteroid use, vasculitis, Raynaud's phenomenon and lipid profile were evaluated. All patients underwent MRI of the hips, knees and ankles using joint-specific MRI. Whole-body STIR (short tau inversion recovery) MRI was performed in all patients with ON lesions.Results: Osteonecrosis was identified in 7 patients (17.5 %) upon joint-specific MRI. Whole-body STIR MRI detected ON in 6 of these 7 patients. There was no significant difference between the ON and non-ON groups in the risk factors studied. One patient had pre-existing symptomatic ON. At 1 year follow-up, the ON lesions had resolved in one patient, remained stable in four and decreased in size in two. No asymptomatic patients with ON developed clinical manifestations.Conclusion: Whole-body STIR MRI may be useful in detecting ON lesions in juvenile SLE patients but larger studies are needed to define its role.