Does rheumatoid arthritis predispose to avn

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I am told by rheumatologists that more of their patients get osteonecrosis of the hip than do people in the general population. There seems to be a view held by them that rheumatoid arthritis predisposes people to ON (at least of the hip).

On the other hand some orthopaedic surgeons seem take the view that this is not the case.

Please can you also tell me whether low dose prednisone, as often prescribed for RA, is seen as safe to take for those who already have avn.

These questions relate to my own case. I have avn of the left hip and have not taken prednisone systemically before or since the disease occurred. As far as can be judged to origin of my avn would seem to be idiopathic.

-- Dr. Peter Baron (barons@clara.net), October 09, 2003

Answers

RA itself is not a risk factor, it is the steroids associated with it that is. If you already have avn, low dose steroids should not affect the hip

-- Harpal Khanuju, M.D. (hkhanuj1@jhmi.edu), January 05, 2004.

After months of joint pain and the HMO's passing me around from doctor to doctor, and x-rays and MRI's, I was diagnosed with osteonecrosis in both knees (today, actually, which is why I'm on this website today). My doctor didn't feel that I fit into any of the categories that are factors in AVN - EXCEPT that one of my doctors back in February thought I might have Rheumatoid Arthritis and put me on Prednisone for about 3 weeks. I don't know if there's a connection, and my Ortho doctor couldn't be certain, but he though that it was certainly possible that the steriod could be a factor - that steriods affect different people different ways.

Anyway, this is all brand new to me, so I'll be sending my questions in. Thanks for being there.

-- Chris Collins (chrisnjan@earthlink.net), December 02, 2004.


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