Avascular necrosis of bone in human immunodeficiency virus infected patients

The objective of this article was to delineate the causes of avascular necr osis (AVN) in patients with human immunodeficiency virus (NN). HIV-infected patients with pain in large joints were prospectively screened. Patients h ad radiographs and magnetic resonance imaging of their affected joints. ser um lipids, anticardiolipin antibody levels (IgG, IgM), and hemoglobin elec trophoresis were performed on all patients who had radiographic studies. Me dical records were screened for factors known to predispose for AVN. Eight patients completed the protocol, and five patents had AVN in seven joints. No common laboratory abnormality was identified in the pa tien ts with AVN. All of the patients with AVN had a history of steroid use; four of five pa tients having taken steroids for HIV-related diseases. The cause of AVN doe s not appear to be directly related to the disease, bu to steroid treatment for manifestations of the disease. (C) Elsevier Science Inc., 2000.