Avascular Osteonecrosis in Systemic Sclerosis Patient: Risk Factors and Role ofVasculopathy?

Abstrak

Avascular Necrosis (AVN) or osteonecrosis refers to the death of osteocytes and
osteoblasts. Sites such as the femoral head, the head of the humerus and the
mandibular with restricted access to local blood supply are particularly vulnerable
to osteonecrosis. Various traumatic and non-traumatic causes of AVN are known,
including systemic autoimmune diseases. Among traumatic causes, physical
trauma, decompression sickness or radiation may be cited. In the non-trauma
cases, two theories are disputed: the first concerns the occurrence of an
intravascular coagulation and the second one attributes the ischemia to
extravascular compression. AVN has been well described in patients with
autoimmune diseases such as systemic lupus erythematosus, but in systemic
sclerosis (SSc) patients, there have been limited case reports and case series. We
present a case of a 32-year old woman with systemic sclerosis on corticosteroid and
avascular osteonecrosis and elaborating possible etiologies or mechanism of
avascular osteonecrosis in SSc.