| Steroid induced osteonecrosis: An analysis of steroid dosing risk. | |
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MedLine Citation:
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PMID: 20621176 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Osteonecrosis is a serious condition involving bone destruction that frequently requires surgical treatment to rebuild the joint. While there is an abundance of literature documenting corticosteroid related osteonecrosis, there is no consensus as to the relative risk of osteonecrosis after administration of steroids via parenteral, oral, topical, inhaled and other routes. This risk is an important prognostic indicator because identification and conservative intervention can potentially reduce morbidity associated with aggressive surgical treatment of osteonecrosis. This paper provides insight into establishing guidelines related to the risk of developing osteonecrosis as a result of corticosteroid use. Case studies, retrospective studies and prospective studies in humans on different corticosteroids and varied dosages were assessed. Most cases of osteonecrosis are secondary to systemically administered corticosteroids and/or high dose daily therapy, particularly in patients with underlying comorbidities including connective tissue diseases, hyperlipidemia, or previous trauma. Previous case reports of osteonecrosis related to inhaled or topical use of steroids are complicated by the fact that in the great majority of cases, the patients are also treated with systemic steroids prior to the development of osteonecrosis. Based on the literature, a set of recommendations regarding the risk of osteonecrosis in patients on steroids was formulated. |
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Authors:
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Christian Powell; Christopher Chang; Stanley M Naguwa; Gurtej Cheema; M Eric Gershwin |
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Publication Detail:
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Type: Journal Article; Review Date: 2010-07-09 |
Journal Detail:
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Title: Autoimmunity reviews Volume: 9 ISSN: 1873-0183 ISO Abbreviation: Autoimmun Rev Publication Date: 2010 Sep |
Date Detail:
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Created Date: 2010-09-03 Completed Date: 2010-12-14 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101128967 Medline TA: Autoimmun Rev Country: Netherlands |
Other Details:
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Languages: eng Pagination: 721-43 Citation Subset: IM |
Copyright Information:
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Copyright 2010 Elsevier B.V. All rights reserved. |
Affiliation:
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Division of Rheumatology, Allergy and Clinical Immunology, University of California at Davis School of Medicine, Davis, CA 95616, United States. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Administration, Oral Adrenal Cortex Hormones / administration & dosage, adverse effects* Animals Bone Density / drug effects* Bone and Bones / drug effects Dose-Response Relationship, Drug Glucocorticoids / administration & dosage, adverse effects Humans Immunosuppressive Agents / administration & dosage, adverse effects Infusions, Parenteral Osteonecrosis / chemically induced* Steroids / administration & dosage, adverse effects* |
| Chemical | |
Reg. No./Substance:
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0/Adrenal Cortex Hormones; 0/Glucocorticoids; 0/Immunosuppressive Agents; 0/Steroids |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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