MAGNETIC-RESONANCE-IMAGING OF THE FEMORAL-HEAD TO DETECT AVASCULAR NECROSIS IN ACTIVE RHEUMATOID-ARTHRITIS TREATED WITH METHYLPREDNISOLONE PULSE THERAPY

Efficacious management of patients with avascular necrosis of bone (AV N) necessitates the identification of patientes with a high risk of co llapse of the femoral head. In this prospective study we imaged both h ips of 10 patients with active rheumatoid arthritis, who were treated with methylprednisolone pulse therapy. MRI and conventional radiograph y were performed before MP-pulse therapy and 6 and 12 months thereafte r. Two patients showed unilateral changes, compatible with AVN. One pa tient became symptomatic and revealed characteristic radiographic abno rmalities. The other patient remained asymptomatic and the MRI appeara nce returned to normal after 6 months.