Prevalence of avascular necrosis in idiopathic inflammatory myopathies: a single-centre experience.
Prevalence of avascular necrosis in idiopathic inflammatory myopathies: a single-centre experience.
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特发性炎症性肌病中股骨头坏死的患病率：单中心经验。
DOI：
10.1093/rheumatology/keab493
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发表时间：
2022
期刊：
影响因子：
--
通讯作者：
Christopher-Stine,Lisa
中科院分区：
文献类型：
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作者：
Bourji,KhalilI;Mecoli,ChristopherA;Paik,JulieJ;Albayda,Jemima;Tiniakou,Eleni;Kelly,William;Lloyd,ThomasE;Mammen,Andrew;Ahlawat,Shivani;Christopher-Stine,Lisa
目的评估特发性炎症性肌病（IIM）患者中缺血性坏死（AVN）的患病率，并确定主要相关危险因素。方法回顾性回顾了2003年至2017年登记的所有明确诊断为IIM的患者的电子病历，并随访至2020年。收集了相关的人口学、临床、血清学和影像学资料。然后选择一组匹配的无AVN患者进行比较。结果1680例患者被诊断为IIM。51例患者发生AVN，总患病率为3%。1085例患者进行了肌肉骨骼MRI检查，46例患者存在AVN（43例下肢和3例上肢MRI研究），相对患病率为4.2%。大多数AVN患者为白人女性（57%），诊断时的平均（s.d）年龄为44.5（12.4）岁。61%的人患有糖尿病，29%的人患有多发性硬化症。从IIM发病到AVN诊断的中位时间为46个月。髋关节最常见，占76%，其次是膝关节，占15%，肩关节占9%。约81%的患者无症状。已确定的AVN危险因素未发现与IIM患者发生AVN相关。结论AVN在IIM中的总体患病率为3%，MRI显示的患病率为4.2%，但多为无症状和偶发。没有发现任何已知的危险因素与AVN的发生有关。
ObjectivesTo assess the prevalence of avascular necrosis (AVN) in a large cohort of patients with idiopathic inflammatory myopathies (IIM) and define the major associated risk factors.MethodsWe retrospectively reviewed the electronic medical records of all patients with a definitive diagnosis of IIM enrolled in our registry between 2003 and 2017, and followed until 2020. Pertinent demographic, clinical, serologic and imaging data were collected. A matched group of patients without AVN was then selected for comparison.ResultsA total of 1680 patients were diagnosed with IIM. Fifty-one patients developed AVN, with an overall prevalence of 3%. Musculoskeletal MRI was available for 1085 patients and AVN was present in 46 patients (43 lower extremities and 3 upper extremities MRI studies), with a relative prevalence of 4.2%. Most patients with AVN were Caucasian females (57%) with a mean (s.d.) age at diagnosis of 44.5 (12.4) years. Sixty-one percent had DM and 29% had PM. The median time from onset of IIM to diagnosis of AVN was 46 months. The hip joint was most commonly involved in 76% of cases, followed by the knee joint in 15% and shoulder joint in 9%. Some 81% of patients were asymptomatic. Established risk factors for AVN were not found to be associated with the development of AVN in IIM patients.ConclusionAlthough mostly asymptomatic and incidental, the overall prevalence of AVN in IIM was 3% and the prevalence by MRI was 4.2%. None of the established risk factors was found to be associated with AVN development.