© 1993 British Society for Rheumatology
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AVASCULAR NECROSIS OF THE HIP IN SYSTEMIC LUPUS ERYTHEMATOSUS: THE ROLE OF MAGNETIC RESONANCE IMAGING
*Departments of Internal Medicine, University of Stellenbosch and Tygerberg Hospital Parow, Cape Town, Republic of South Africa
Departments of Orthopaedic Surgery, University of Stellenbosch and Tygerberg Hospital Parow, Cape Town, Republic of South Africa
Departments of Nuclear Medicine, University of Stellenbosch and Tygerberg Hospital Parow, Cape Town, Republic of South Africa
Departments of Radiology, University of Stellenbosch and Tygerberg Hospital Parow, Cape Town, Republic of South Africa
Correspondence to:
Correspondence to A. Halland, P.O. Box 19063, Tygerberg 7505. Republic of South Africa
The value of magnetic resonance imaging (MRI) in the early diagnosis of avascular necrosis (AVN) of the hip in SLE was investigated.
Twenty females with severe SLE were studied prospectively. Each underwent 6-monthly X-rays, technetium -99m (Tc-99m) pyrophosphate bone scans and MRI of the hips over a 3-yr period.
AVN was diagnosed in five hips of three patients (15%) during the study period. It was confirmed histologically in three hips of two patients who underwent core decompression. Radiological evidence of AVN was present in two patients at diagnosis. One patient developed progressive radiological changes despite core decompression. Bone scintigraphy was abnormal at some stage in all three patients with AVN however failed to detect the early ischaemic stage of AVN.
MRI was the most reliable investigation and was able to detect asymptomatic AVN prior to the appearance of radiological or scintigraphic abnormalities.
KEY WORDS: Osteonecrosis, Core decompression, Femur
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