| Objective To analyze the clinical features, bone mineral density (BMD), and the treatment and prognosis of systemic lupus erythematosus (SLE) with osteonecrosis (ON), in order to make early diagnosis and timely intervention. Methods The SLE patients with ON in the rheumatology department of the Fourth Medical Center of the General Hospital of the PLA were enrolled. The clinical data, BMD results, and the magnetic resonance imaging results of the involved joints were collected and analyzed. Results Fourteen SLE patients developed ON, which constituted 15% of SLE hospitalized patients. Twelve patients were females. Patients developed ON with a median age of 35 years. The mean duration of SLE was 61 months when osteonecrosis occurred. The interval from the onset of symptoms to diagnosis was 1 to 17 weeks. The mean SLE disease activity index (SLEDAI) was 3 points in ON patients. ON was common in patients with kidney, joints, and blood system involvement. Twelve patients had multiple ON. The incidence of ON of the femoral head（ONF）was equal to that of ON of the knee (ONK). Among 8 patients with osteopenia, 7 patients developed ONF. Among 4 patients with osteoporosis, 3 developed ONK. Two patients with normal BMD developed ONK after corticosteroids pulse therapy. Conclusion ON is not uncommon in SLE patients. The incidence of ONF and ONK is similar in hospitalized patients. Patients with kidney, joint, and blood system involvement, low BMD, and long-term glucocorticoid therapy are prone to develop ON. |