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. 2009 Nov;14 Suppl 1(Suppl 1):79-84.
doi: 10.1111/j.1365-3156.2008.02187.x. Epub 2009 Jun 5.

Avascular osteonecrosis after treatment of SARS: a 3-year longitudinal study

Hui Lv  1 , Sake J de Vlas, Wei Liu, Tian-Bao Wang, Zhao-Yang Cao, Chun-Peng Li, Wu-Chun Cao, Jan Hendrik Richardus
Affiliations

Avascular osteonecrosis after treatment of SARS: a 3-year longitudinal study

Hui Lv et al. Trop Med Int Health. 2009 Nov.

Abstract

Objective: To investigate the relationship between avascular osteonecrosis (AVN) and corticosteroid treatment given to patients with severe acute respiratory syndrome (SARS).

Methods: Longitudinal study of 71 former SARS patients (mainly health care workers) who had been treated with corticosteroids, with an observation time of 36 months. Magnetic resonance images (MRI) and X-rays of hips, knees, shoulders, ankles and wrists were taken as part of the post-SARS follow-up assessments.

Results: Thirty-nine per cent developed AVN of the hips within 3-4 months after starting treatment. Two more cases of hip necrosis were seen after 1 year and another 11 cases of AVN were diagnosed after 3 years, one with hip necrosis and 10 with necrosis in other joints. In total, 58% of the cohort had developed AVN after 3 years of observation. The sole factor explaining AVN in the hip was the total dose of corticosteroids received.

Conclusion: The use of corticosteroids in SARS has been debated; opinions conflict about whether the immediate benefits in terms of saving lives compensate for the adverse effects, including AVN.

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Conflict of interest statement

The authors have declared that they have no conflicts of interest.

Figures

Figure 1
Figure 1
(a) MRI image of hip joints with bilateral AVN in a former SARS patient treated with corticosteroids. (b) MRI image of knee joint with AVN in a former SARS patient treated with corticosteroids.
See this image and copyright information in PMC

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