Aseptic Osseous Necrosis and Corticosteroid Therapy

Summary

Aseptic osseous necrosis was found in 31 patients with rheumatoid arthritis. In order to study the appearance of peripheral neuropathy in cases with osseous necrosis the skin and vibration sensibilities were examined by a specially devised method. Besides on control subjects, the examination was made on 26 patients with rheumatoid arthritis, 16 of whom belonged to the aseptic necrosis group and 10 had a severe grade of disease but without necrosis. Sensibility defects were found in 11 patients, who belonged to both groups.

The series indicates that the use of corticosteroids does not have a decisive role in the development of aseptic osseous necrosis, and neither have sensibility disturbances.

A common roentgenological observation was that the sequestrum will be absorbed and disappear, the ultimate outcome being joint destruction and deformity, resembling neuropathic arthropathy.