ABSTRACT
Osteoarticular manifestations usually are not listed in the clinical features of the antiphospholipid syndrome (APS). It has been reported that patients with APS or isolated anticardiolipin antibodies (aCL) might have an increased risk of developing avascular necrosis (AVN) of bone, independently of steroid therapy, suggesting that a relationship might exist between AVN and aCL. Several reports of AVN occurring in patients with systemic lupus erythematosus (SLE), primary APS, or aCL, in the absence of previous steroid administration, directly suggest that such an association might exist. As noted by Ronald A. Asherson et al., arthritis is only found in SLE, whereas arthralgias are not uncommon in primary APS. Avascular necrosis has been added to the list of osteoarticular complications of human immunodeficiency virus (HIV)-infected patients. Abnormalities of coagulation and fibrinolysis pathways have been described in HIV-infected patients and therefore could participate in the local necrosis process.
