TY - JOUR
T1 - Multifocal osteonecrosis in a patient with anamnestic ulcerative colitis. Is there a relationship with the disease and the use of glucocorticoids twenty years before? A brief review of the literature
AU - Saviola, Gianantonio
AU - Abdi-Ali, L.
AU - Sacco, S.
AU - G. Dalle Carbonare, L.
PY - 2016
Y1 - 2016
N2 - In 2013 a 40 year old man came to visit in our Rh eum atology Unit becaus e of a recent bilateral sh oulder and hip pain. He had been treated from 1990 to 2000 with Cyclosporin A and Sulfasalazyn becaus e of an ulcerative colitis which was completely in remiss ion from 2000 . Glucocorticoids at th e mean daily dose of 50 mg were administ ered only in th e first period (1990-92) X- plain raysys shshowed a sussussuspiciousus mumultifocal oststeonecrosis of bothth femoral and hum eral heads. Magnetic Resonance confirmed th e diagnosis (st age III and IV following Ficat and Arlet's criteria). The patient was treated with a cycle of hyhyperbaric oxyg en th erapy, with two cycles of intravenous clodronate and with a 2-month cycle of teriparatide. The treatmtment was able to save a sufsufsufficient fufunction for bothth shshoulders, while for both hips arth roplasty th e su rgery was required. The risks of ost eonecrosis linked to inflammatory bowel diseases or to its th erapy are discussed.
AB - In 2013 a 40 year old man came to visit in our Rh eum atology Unit becaus e of a recent bilateral sh oulder and hip pain. He had been treated from 1990 to 2000 with Cyclosporin A and Sulfasalazyn becaus e of an ulcerative colitis which was completely in remiss ion from 2000 . Glucocorticoids at th e mean daily dose of 50 mg were administ ered only in th e first period (1990-92) X- plain raysys shshowed a sussussuspiciousus mumultifocal oststeonecrosis of bothth femoral and hum eral heads. Magnetic Resonance confirmed th e diagnosis (st age III and IV following Ficat and Arlet's criteria). The patient was treated with a cycle of hyhyperbaric oxyg en th erapy, with two cycles of intravenous clodronate and with a 2-month cycle of teriparatide. The treatmtment was able to save a sufsufsufficient fufunction for bothth shshoulders, while for both hips arth roplasty th e su rgery was required. The risks of ost eonecrosis linked to inflammatory bowel diseases or to its th erapy are discussed.
KW - Clodronate
KW - Glucocorticoid induced osteonecrosisost
KW - Multifocal avascular osteonecrosis
KW - Ulcerative colitis
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U2 - 10.7417/CT.2016.1941
DO - 10.7417/CT.2016.1941
M3 - Review article
AN - SCOPUS:84991389338
VL - 167
SP - 121
EP - 123
JO - Clinica Terapeutica
JF - Clinica Terapeutica
SN - 0009-9074
IS - 4
ER -