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Aim of the work To evaluate haemodynamic changes in the femoral head in systemic lupus erythematosus (SLE) patients and to compare these haemodynamic changes between SLE patients with or without associated risk factors for ON. To determine the effect of various risk factors on the blood flow to the proximal femur. Patients and methods Evaluation of the blood vessels supplying the femoral heads bilaterally [medial and lateral circumflex femoral arteries (MCA and LCA)], by color and power Doppler (CD/PD) ultrasound (US). Arterial pulsatility index (PI) and peak systolic velocity (PSV) were determined in both neutral and internal rotation positions (simulated ischemia). Results • Both the PI and PSV values were significantly higher in SLE patients with associated risk factors for ON compared to those with no associated risk factors for ON (p  • The PI value correlated inversely with PSV in both SLE patients and controls (p  • PSV increased simultaneously with the decline of PI value in both SLE patients and controls after internal rotation of the femoral head (simulated ischemia). • The PI showed significant direct correlation with steroid dose (p = 0.04), but not the duration of steroid use (p = 0.47), Raynaud’s phenomenon (p = 0.03) and serositis (pleural effusion) (p = 0.02). Conclusion The presence of associated risk factors for ON contributes to haemodynamic flow changes. Color Doppler ultrasound represents a useful tool for the assessment and follow-up for haemodynamic deterioration of hip vascularity in both hip joints.

the egyptian rheumatologist

Ultrasonographic evaluation of haemodynamic flow changes to the hip in systemic lupus erythematosus patients: Correlation with risk factors for osteonecrosis