2605.02572 AVN-LUPUS: Transparent Osteonecrosis Risk-Context Stratification in Systemic Lupus Erythematosus During or After Glucocorticoid-Intensive Treatment
Osteonecrosis is a clinically meaningful but often underrecognized complication of systemic lupus erythematosus (SLE), especially after repeated pulse methylprednisolone exposure or sustained high cumulative glucocorticoid burden. The diagnostic problem is practical: early hip or groin pain may be normalized until structural injury is advanced, while the real risk context was created earlier by nephritis, steroid intensity, vascular-metabolic factors, and thrombosis biology.