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Abstract Number: 1095

Avascular Necrosis in the Hopkins Myositis Cohort: A Single Center Experience

Khalil Bourji1, Christopher Mecoli2, Julie Paik3, Jemima Albayda3, Eleni Tiniakou3, William Kelly3, Thomas E Lloyd3, Andrew Mammen4 and Lisa Christopher-Stine3, 1Wayne State University/Henry Ford Hospital, Dearborn, MI, 2Johns Hopkins University School of Medicine, Baltimore, MD, 3Johns Hopkins University, Baltimore, MD, 4NIH, Bethesda, MD

Meeting: ACR Convergence 2020

Keywords: Myositis, Work Force

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Session Information

Date: Sunday, November 8, 2020

Session Title: Muscle Biology, Myositis & Myopathies Poster

Session Type: Poster Session C

Session Time: 9:00AM-11:00AM

Background/Purpose: To assess the prevalence of avascular necrosis (AVN) in a large cohort of patients with idiopathic inflammatory myopathies (IIM) and define the major associated risk factors.

Methods: We retrospectively reviewed the electronic medical records of all patients with a definitive diagnosis of IIM in our cohort, querying for keywords (“avascular necrosis”, “AVN”, “osteonecrosis”). Pertinent demographic, clinical (including major risk factors for AVN), serologic and imaging data were collected. A matched group of patients without AVN was then selected for comparison (matched for sex, age at IIM diagnosis ± 2 years, and duration of IIM ± 1 year).

Results: A total of 1680 patients were diagnosed with IIM between 2003 and 2017. Fifty-three patients developed AVN, with a global prevalence of 3.1% (53/1680). Musculoskeletal magnetic resonance imaging (MSK MRI) was available for 1085 patients and AVN was present in 48 patients, with a relative prevalence of 4.4% (48/1085). The majority of patients were Caucasian females (57%) with a mean age at diagnosis of 44.512.4 years. 59% had dermatomyositis (DM), 28% had polymyositis (PM). The median time from diagnosis of IIM to diagnosis of AVN was 46 months. Only 18 % were symptomatic. Hip joint was involved in 77%, Knee joint in 16% and Shoulder joint in 7%. A history of alcohol use was the only risk factor that was statistically associated with AVN (36% vs 13%; OR=3.98, CI [1.31-12.0], p=0.01). Corticosteroid use was not associated with an increased risk of AVN.

Conclusion: Although mostly asymptomatic, the global prevalence of AVN in IIM was 3.1% but the prevalence on MSK MRI was 4.4% and alcohol use was the only risk factor for AVN development.


Disclosure: K. Bourji, None; C. Mecoli, None; J. Paik, None; J. Albayda, None; E. Tiniakou, None; W. Kelly, None; T. Lloyd, None; A. Mammen, None; L. Christopher-Stine, None.

To cite this abstract in AMA style:

Bourji K, Mecoli C, Paik J, Albayda J, Tiniakou E, Kelly W, Lloyd T, Mammen A, Christopher-Stine L. Avascular Necrosis in the Hopkins Myositis Cohort: A Single Center Experience [abstract]. Arthritis Rheumatol. 2020; 72 (suppl 10). https://acrabstracts.org/abstract/avascular-necrosis-in-the-hopkins-myositis-cohort-a-single-center-experience/. Accessed May 16, 2022.
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