Avascular necrosis in SLE An apparent predilection for young patients

patients. Recent reports of avascular necrosis (AN) in systemic lupus erythematosus (SLE) have suggested that its occurrence may be most frequent in young patients. In our population of 99 patients with SLE, 7 young patients have developed AN. Patterns of prednisone therapy had no apparent relationship to the development of AN. AN may become apparent in patients who have relatively inactive lupus, when increased physical activity precipitates articular collapse. A diagnosis ofAN should be considered in young patients with localized joint pain. Avascular necrosis (AN) was first reported in associa-tion with systemic lupus erythematosus (SLE) in 1960 (Dubois and Cozen, 1960). Subsequent reports have provided evidence that AN in SLE is a relatively common occurrence. Two recent studies in the paedia-tric literature note an incidence of 40 % in paediatric populations (Hurley and others, 1974; Bergstein and others, 1974), and one of these notes that asympto-matic AN may be much more common than pre-viously recognized. We present an assessment of our lupus patients who have developed symptomatic avascular necrosis, with an attempt to define the patient population in which it occurs and to determine predisposing factors