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- Title
High prevalence of osteonecrosis of the femoral head in HIV-infected adults.
- Authors
Miller, Kirk D.; Masur, Henry; Jones, Elizabeth C.; Joe, Galen O.; Rick, Margeret E.; Kelly, Grace G.; Mican, JoAnn M.; Shuying Liu; Gerber, Lynn H.; Blackwelder, William C.; Falloon, Judith; Davey Jr., Richard T.; Polis, Michael A.; Walker, Robert E.; Lane, Clifford; Kovacs, Joseph A.; Rick, Margaret E; Liu, Shuying; Davey, Richard T; Lane, H Clifford
- Abstract
<bold>Background: </bold>Osteonecrosis has been reported to occur occasionally among HIV-infected patients. The diagnosis of symptomatic osteonecrosis of the hip in two of the authors' patients, together with reports from community physicians, raised a concern that the prevalence of osteonecrosis is increasing.<bold>Objective: </bold>To determine the prevalence of osteonecrosis of the hip in asymptomatic HIV-infected patients and to identify potential risk factors associated with osteonecrosis.<bold>Design: </bold>Survey and comparison study.<bold>Setting: </bold>The Clinical Center of the U.S. National Institutes of Health.<bold>Participants: </bold>339 asymptomatic HIV-infected adults (of 364 asked to participate) and 118 age- and sex-matched HIV-negative volunteers enrolled between 1 June and 15 December 1999.<bold>Measurements: </bold>Osteonecrosis of the hip, as documented by magnetic resonance imaging. Data from clinic records and a patient questionnaire administered before magnetic resonance imaging were used in an analysis of risk factors. A subset of patients was evaluated for hypercoagulable state.<bold>Results: </bold>Fifteen (4.4% [95% CI, 2.5% to 7.2%]) of 339 HIV-infected participants had osteonecrosis lesions on magnetic resonance imaging, and no HIV-negative participants had similar lesions. Among HIV-infected participants, osteonecrosis occurred more frequently in those who used systemic corticosteroids, lipid-lowering agents, or testosterone; those who exercised routinely by bodybuilding; and those who had detectable levels of anticardiolipin antibodies.<bold>Conclusions: </bold>Patients infected with HIV have an unexpectedly high occurrence of osteonecrosis of the hip. Although screening asymptomatic patients is not warranted, HIV-infected patients with persistent groin or hip pain should be evaluated for this debilitating complication.
- Subjects
OSTEONECROSIS; HIV
- Publication
Annals of Internal Medicine, 2002, Vol 137, Issue 1, p17
- ISSN
0003-4819
- Publication type
journal article
- DOI
10.7326/0003-4819-137-1-200207020-00008