Editorial Comment Steroid-related osteonecrosis—an update

The use of systemic corticosteroids is common in patients with a variety of different renal diseases. Low-dose oral corticosteroids are part of many long-term treatment protocols for patients following renal transplantation or with different forms of glomerulonephritis and systemic autoimmune diseases, i.e. systemic lupus erythematosus or vasculitis. High-dose intravenous corticosteroids are typically used for short durations to treat transplant rejection episodes or for the induction of remission in highly active autoimmune diseases. Osteonecrosis (ON) is a well-known and feared complication in patients with renal diseases undergoing systemic corticosteroid therapy. It predominantly occurs in the femoral head (FH) (FH necrosis, FHN; Figure 1), but also in the proximal humerus, the knee and the ankle [1]