title: Musculoskeletal complications of systemic lupus erythematosus in the Hopkins Lupus Cohort: an update.
abstract: OBJECTIVE
  To determine the frequency of musculoskeletal system damage among patients in the Hopkins Lupus Cohort, over time, and to determine predictors of musculoskeletal damage (including avascular necrosis of bone, osteoporosis, and fracture) in the same cohort.
  
  
  METHODS
  Evaluation of the cohort visit database (from 1989 or at the time of entry into the cohort if later than 1989) for the 407 patients with systemic lupus erythematosus (SLE). Musculoskeletal damage was measured by the SLICC/ACR Damage Index.
  
  
  RESULTS
  Total damage and musculoskeletal damage accumulated from the time of diagnosis of SLE, and musculoskeletal damage continued over time, with avascular necrosis of bone being the most common form. African-Americans and SLE patients of lower socioeconomic status were more likely to experience musculoskeletal damage. Use of corticosteroids was a major risk factor for both avascular necrosis of bone and osteoporosis.
  
  
  CONCLUSIONS
  Musculoskeletal damage remains one of the major sequela of SLE. Reduction of the modifiable risk factors (especially prednisone dose) is the key to both primary and secondary prevention efforts.
authors.forename: M
authors.initials: M
authors.lastname: Petri
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications*; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000209:etiology* / Q000517:prevention & control; D011237:Predictive Value of Tests; D012307:Risk Factors; D013997:Time Factors