AB1660 ASSOCIATION OF COMMON COMORBIDITIES WITH ASEPTIC OSTEONECROSIS: EXPERIENCE OF RHEUMATOLOGY DEPARTMENT

Abstract

BackgroundOsteonecrosis (ON) (avascular necrosis, aseptic necrosis or subchondral avascular necrosis) is not a specific disease entity but the final common pathway of a number of conditions leading to bone death [1].ObjectivesTo examine the frequency of ON and to investigate different common comorbidities association with ON in a rheumatology department.MethodsAll patients with a first-time hospital diagnosis of ON in rheumatology department during 1995–2022 were included. We obtained a complete hospital history of comorbidities preceding the diagnosis of ON.Results43 ON cases were included with an average of 1.6 cases/year. The mean age of our patients was 53 years (27-82). The sex-ratio male to female was 1,75 (12 females and 21 males).The different sites of osteonecrosis were distributed as follows: femoral head, femoral condyle, semilunar and humeral head.The diagnosis of ON was confirmed by simple radiography in15 cases, bone scan in 14 cases and with magnetic resonance imagery in 14 cases.Dyslipidemia was the most common comorbidity (13.9 % of patients), followed by high blood pressure, hypothyroidism, allergic asthma, obesity, alcohol abuse, renal failure, rheumatoid arthritis, diabetes, gout, hemopathy, trauma, and coronary artery disease.Among these chronic conditions, the most common recognized risk factor of ON in our series was medications (corticosteroids) followed by dyslipidemia, alcohol abuse, hemopathy (sickle cell anemia, Hodgkin’s lymphoma and beta thalassemia) and trauma (fractures and dislocation of the hip).All patients received medical treatment based on painkillers and functional rehabilitation.12 patients had surgical treatment: 8 total hip prosthesis, 3 Core decompression and bone marrow aspirate concentrate injection for Avascular Necrosis of the femoral head and 1 Proximal row carpectomy for semilunar osteonecrosis.ConclusionThis monocentric study provides evidence for an increasing ON incidence associated to systemic steroid administration. Hence the need for early and adequate management of this factor to prevent possible complications such as aseptic osteonecrosis.Reference[1]Pavelka K. Osteonecrosis. Baillieres Best Pract Res Clin Rheumatol. 2000 Jun;14(2):399-414. doi: 10.1053/berh.2000.0072. PMID: 10925752.Acknowledgements:NIL.Disclosure of InterestsNone Declared.