Top

European Orthopaedics and Traumatology

Published in:

01-12-2013 | Original Article

Incidence of steroid-associated osteonecrosis of the talus: a prospective MRI study

Authors: Tomonori Shigemura, Junichi Nakamura, Yoshitada Harada, Masaaki Sakamoto, Kazuhisa Takahashi, Shunji Kishida

Published in: European Orthopaedics and Traumatology | Issue 4/2013

Abstract

Objective

The purpose of this study was to determine the incidence of steroid-associated osteonecrosis (ON) of the talus in systemic lupus erythematosus (SLE) patients using a prospective magnetic resonance imaging (MRI) study.

Methods

We prospectively evaluated 110 SLE patients (220 tali) who required corticosteroid therapy using MRI. The incidence of ON of the talus was compared with the incidence of ON of the femoral head. We also divided these patients into two groups: those with and without ON of the talus. We compared these groups for gender differences, ages at initial corticosteroid therapy, and highest daily corticosteroid dosages.

Results

The incidence of ON of the talus was significantly lower than the incidence of ON of the femoral head (7.3 versus 49.5 %; p < 0.001). No significant differences for gender, age at initial corticosteroid therapy, or highest daily corticosteroid dosage were observed between patients with and without ON of the talus. The rate of ON of the bilateral femoral head was significantly higher in those with ON of the talus than in those without ON of the talus.

Conclusion

Our results revealed that the incidence of ON of the talus was significantly lower than the incidence of ON of the femoral head.

Canale ST, Kelly FB Jr (1978) Fractures of the neck of the talus. Long-term evaluation of seventy-one cases. J Bone Joint Surg Am 60:143–156PubMed

Adelaar RS, Madrian JR (2004) Avascular necrosis of the talus. Orthop Clin North Am 35:383–395, xi. ReviewPubMedCrossRef

Babu N, Schuberth JM (2010) Partial avascular necrosis after talar neck fracture. Foot Ankle Int 31:777–780PubMedCrossRef

Ohl X, Harisboure A, Hemery X, Dehoux E (2011) Long-term follow-up after surgical treatment of talar fractures: twenty cases with an average follow-up of 7.5 Years. Int Orthop 35:93–99PubMedCrossRef

Mont MA, Schon LC, Hungerford MW, Hungerford DS (1996) Avascular necrosis of the talus treated by core decompression. J Bone Joint Surg Br 78:827–830PubMed

Dennis MD, Tullos HS (1980) Blair tibiotalar arthrodesis for injuries to the talus. J Bone Joint Surg Am 62:103–107PubMed

Kitaoka HB, Patzer GL (1998) Arthrodesis for the treatment of arthrosis of the ankle and osteonecrosis of the talus. J Bone Joint Surg Am 80:370–379PubMedCrossRef

Zvijac JE, Lemak L, Schurhoff MR, Hechtman KS, Uribe JW (2002) Analysis of arthroscopically assisted ankle arthrodesis. Arthroscopy 18:70–75PubMed

Manes HR, Alvarez E, Llevine LS (1977) Preliminary report of total ankle arthroplasty for osteonecrosis of the talus. Clin Orthop Relat Res 127:200–202PubMed

10.

Adleberg JS, Smith GH (1991) Corticosteroid-induced avascular necrosis of the talus. J Foot Surg 30:66–69PubMed

11.

Tasic V, Trajkovski Z, Zafirovski G, Gucev Z, Trompeter RS (2006) Aseptic necrosis of both tali in a child with steroid-dependent nephrotic syndrome. Nephrol Dial Transplant 21:1702–1704PubMedCrossRef

12.

Kubo T, Yamazoe S, Sugano N, Fujioka M, Naruse S, Yoshimura N, Oka T, Hirasawa Y (1997) Initial MRI findings of non-traumatic osteonecrosis of the femoral head in renal allograft recipients. Magn Reson Imaging 15:1017–1023PubMedCrossRef

13.

Torii Y, Hasegawa Y, Kubo T, Kodera Y, Minami S, Morishita Y, Yamada Y, Iwata H (2001) Osteonecrosis of the femoral head after allogeneic bone marrow transplantation. Clin Orthop Relat Res 382:124–132PubMedCrossRef

14.

Oinuma K, Harada Y, Nawata Y, Takabayashi K, Abe I, Kamikawa K, Moriya H (2001) Osteonecrosis in patients with systemic lupus erythematosus develops very early after starting high dose corticosteroid treatment. Ann Rheum Dis 60:1145–1148PubMedCrossRef

15.

Nakamura J, Harada Y, Oinuma K, Iida S, Kishida S, Takahashi K (2010) Spontaneous repair of asymptomatic osteonecrosis associated with corticosteroid therapy in systemic lupus erythematosus: 10-year minimum follow-up with MRI. Lupus 19:1307–1314PubMedCrossRef

16.

Nakamura J, Ohtori S, Sakamoto M, Chuma A, Abe I, Shimizu K (2010) Development of new osteonecrosis in systemic lupus erythematosus patients in association with long-term corticosteroid therapy after disease recurrence. Clin Exp Rheumatol 28:13–18PubMed

17.

Sugano N, Atsumi T, Ohzono K, Kubo T, Hotokebuchi T, Takaoka K (2002) The 2001 revised criteria for diagnosis, classification, and staging of idiopathic osteonecrosis of the femoral head. J Orthop Sci 7:601–605PubMedCrossRef

18.

Nakamura J, Saisu T, Yamashita K, Suzuki C, Kamegaya M, Takahashi K (2010) Age at time of corticosteroid administration is a risk factor for osteonecrosis in pediatric patients with systemic lupus erythematosus: a prospective magnetic resonance imaging study. Arthritis Rheum 62:609–615PubMedCrossRef

19.

Shigemura T, Nakamura J, Kishida S, Harada Y, Ohtori S, Kamikawa K, Ochiai N, Takahashi K (2011) Incidence of osteonecrosis associated with corticosteroid therapy among different underlying diseases: prospective MRI study. Rheumatol (Oxford) 50:2023–2028CrossRef

20.

Felson DT, Anderson JJ (1987) A cross-study evaluation of association between steroid dose and bolus steroids and avascular necrosis of bone. Lancet 1:902–905PubMedCrossRef

21.

Atsumi T, Kuroki Y, Yamano K (1989) A microangiographic study of idiopathic osteonecrosis of the femoral head. Clin Orthop Relat Res 246:186–194PubMed

22.

Atsumi T, Kuroki Y (1992) Role of impairment of blood supply of the femoral head in the pathogenesis of idiopathic osteonecrosis. Clin Orthop Relat Res 277:22–30PubMed

23.

Atsumi T, Kuroki Y, Yamano K, Muraki M (1996) Revascularization in nontraumatic osteonecrosis of the femoral head. Clin Orthop Relat Res 325:168–173PubMedCrossRef

24.

Mulfinger GL, Trueta J (1970) The blood supply of the talus. J Bone Joint Surg Br 52:160–167PubMed

25.

Pearce DH, Mongiardi CN, Fornasier VL, Daniels TR (2005) Avascular necrosis of the talus: a pictorial essay. RadioGraphics 25:399–410, ReviewPubMedCrossRef

26.

Miller AN, Prasarn ML, Dyke JP, Helfet DL, Lorich DG (2011) Quantitative assessment of the vascularity of the talus with gadolinium-enhanced magnetic resonance imaging. J Bone Joint Surg Am 93:1116–1121PubMedCrossRef

Title: Incidence of steroid-associated osteonecrosis of the talus: a prospective MRI study
Authors: Tomonori Shigemura
Junichi Nakamura
Yoshitada Harada
Masaaki Sakamoto
Kazuhisa Takahashi
Shunji Kishida
Publication date: 01-12-2013
Publisher: Springer Berlin Heidelberg
Published in: European Orthopaedics and Traumatology / Issue 4/2013
Print ISSN: 1867-4569
Electronic ISSN: 1867-4577
DOI: https://doi.org/10.1007/s12570-013-0176-4

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Incidence of steroid-associated osteonecrosis of the talus: a prospective MRI study

Abstract

Objective

Methods

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Objective

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 4/2013

Transformation of a giant cell tumor of bone into a secondary malignant fibrous histiocytoma

The formation of cracks at cement interfaces of different femoral stem designs

Isolated dislocation of pisiform in an 11-year-old, following a horse bite: a rare injury

Open irreducible fracture/dislocation of the four ulnar metacarpals at the metacarpophalangeal joints: case report

Meralgia paresthetica due to a thigh hibernoma: a rare diagnosis—case report

Ganglion cyst or meniscal cyst—a dilemma!