<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2301-1254</journal-id>
<journal-title><![CDATA[Anales de la Facultad de Medicina]]></journal-title>
<abbrev-journal-title><![CDATA[Anfamed]]></abbrev-journal-title>
<issn>2301-1254</issn>
<publisher>
<publisher-name><![CDATA[Universidad de la República. Facultad de Medicina]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2301-12542023000201303</article-id>
<article-id pub-id-type="doi">10.25184/anfamed2023v10n2a5</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Osteonecrosis Múltiple inducida por glucocorticoides.]]></article-title>
<article-title xml:lang="en"><![CDATA[Multiple osteonecrosis induced bye glucocorticoids.]]></article-title>
<article-title xml:lang="pt"><![CDATA[Osteonecrose múltipla induzida por glicocorticóides.]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Bruzzese]]></surname>
<given-names><![CDATA[Juan Pablo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Harretche]]></surname>
<given-names><![CDATA[Gonzalo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Porcelli]]></surname>
<given-names><![CDATA[Daniel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rodriguez]]></surname>
<given-names><![CDATA[Claudio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad de la República Traumatología y ortopedia ]]></institution>
<addr-line><![CDATA[Montevideo ]]></addr-line>
<country>Uruguay</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidad de la República Traumatología y ortopedia ]]></institution>
<addr-line><![CDATA[Montevideo ]]></addr-line>
<country>Uruguay</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2023</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2023</year>
</pub-date>
<volume>10</volume>
<numero>2</numero>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_arttext&amp;pid=S2301-12542023000201303&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_abstract&amp;pid=S2301-12542023000201303&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_pdf&amp;pid=S2301-12542023000201303&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen: La osteonecrosis múltiple es una entidad poco frecuente que se define por el compromiso de al menos tres regiones diferentes. Es indispensable el abordaje multidisciplinario de los pacientes que la padecen tanto para el diagnóstico como el tratamiento oportuno. Presentamos el caso clínico de un paciente joven que presenta una osteonecrosis múltiple con compromiso de ambas caderas, hombros, rodillas, codo derecho y cuello de pie izquierdo. El principal factor de riesgo presente en nuestro caso es el consumo de glucocorticoides.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract: Multiple osteonecrosis is a rare entity that is defined by the involvement of at least three different regions. A multidisciplinary approach to patients who suffer from it is essential for both diagnosis and timely treatment. We present the clinical case of a young patient who presented multiple osteonecrosis with involvement of both hips, shoulders, knees, right elbow, and neck of the left foot. The main risk factor present in our case is the consumption of glucocorticoids.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo: A osteonecrose múltipla é uma entidade rara que se define pelo envolvimento de pelo menos três regiões diferentes. Uma abordagem multidisciplinar aos pacientes que sofrem com isso é essencial para o diagnóstico e tratamento oportuno. Apresentamos o caso clínico de um paciente jovem que apresenta osteonecrose múltipla envolvendo quadris, ombros, joelhos, cotovelo direito e pescoço do pé esquerdo. O principal fator de risco presente no nosso caso é o consumo de glicocorticóides.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Osteonecrosis]]></kwd>
<kwd lng="es"><![CDATA[osteonecrosis multiple]]></kwd>
<kwd lng="es"><![CDATA[glucocorticoides]]></kwd>
<kwd lng="es"><![CDATA[paciente jóven]]></kwd>
<kwd lng="es"><![CDATA[artroplastia]]></kwd>
<kwd lng="en"><![CDATA[Osteonecrosis]]></kwd>
<kwd lng="en"><![CDATA[multiple osteonecrosis]]></kwd>
<kwd lng="en"><![CDATA[glucocorticoids]]></kwd>
<kwd lng="en"><![CDATA[young patient]]></kwd>
<kwd lng="en"><![CDATA[arthroplasty]]></kwd>
<kwd lng="pt"><![CDATA[Osteonecrose]]></kwd>
<kwd lng="pt"><![CDATA[osteonecrose múltipla]]></kwd>
<kwd lng="pt"><![CDATA[glicocorticóides]]></kwd>
<kwd lng="pt"><![CDATA[paciente jovem]]></kwd>
<kwd lng="pt"><![CDATA[artroplastia]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Gómez-Puerta]]></surname>
<given-names><![CDATA[JA]]></given-names>
</name>
<name>
<surname><![CDATA[Peris]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Guañabens]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Osteonecrosis múltiple Patogénesis, Características clínicas y tratamiento]]></article-title>
<source><![CDATA[Seminarios de la fundación española de Reumatología]]></source>
<year>2007</year>
<volume>8</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>185-92</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Martínez-Ferrer]]></surname>
<given-names><![CDATA[MA]]></given-names>
</name>
<name>
<surname><![CDATA[Peris]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Guañabens]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Osteonecrosis ¿Qué hay de nuevo?. Reumatolo]]></article-title>
<source><![CDATA[Clin]]></source>
<year>2007</year>
<volume>3</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>78-84</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Sun]]></surname>
<given-names><![CDATA[W]]></given-names>
</name>
<name>
<surname><![CDATA[Shin]]></surname>
<given-names><![CDATA[Z]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The pathogenesis of multifocal osteonecrosis]]></article-title>
<collab>Gao F et al</collab>
<source><![CDATA[Scientific Reports]]></source>
<year>2016</year>
<volume>6</volume>
<page-range>29576</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Seamon]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Keller]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Saleh]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<source><![CDATA[The patogenesis of nontraumatic osteonecrosis]]></source>
<year>2012</year>
<page-range>11</page-range><publisher-name><![CDATA[Hindawi Pub. Corp]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Krez]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Lane]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Risk factors for multi-joint disease in patients with glucocorticoid-induced osteonecrosis]]></article-title>
<collab>Heilbronner A et al</collab>
<source><![CDATA[Osteoporosis International]]></source>
<year>2021</year>
<volume>32</volume>
<page-range>2095-103</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Zhang]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Li]]></surname>
<given-names><![CDATA[Z]]></given-names>
</name>
<name>
<surname><![CDATA[Wei]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Steroid-induced osteonecrosis. The number of lesions is related to the dosage]]></article-title>
<source><![CDATA[J Bone Joint Surg]]></source>
<year>2008</year>
<numero>90-B</numero>
<issue>90-B</issue>
<page-range>1239-43</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Flouzat-Lachaniette]]></surname>
<given-names><![CDATA[CH]]></given-names>
</name>
<name>
<surname><![CDATA[Roubineau]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Multifocal osteonecrosis related to corticosteroid ten years later, risk of progression and observation of subsequent new osteonecroses.International]]></article-title>
<collab>Heyberger C et al</collab>
<source><![CDATA[Orthopaedics (SICOT)]]></source>
<year>2016</year>
<volume>40</volume>
<page-range>669-72</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Laporte]]></surname>
<given-names><![CDATA[DM]]></given-names>
</name>
<name>
<surname><![CDATA[Mont]]></surname>
<given-names><![CDATA[MA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Multifocal osteonecrosis]]></article-title>
<collab>Mohan V et al</collab>
<source><![CDATA[J Rheumatol]]></source>
<year>1998</year>
<numero>25</numero>
<issue>25</issue>
<page-range>1968-74</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Gómez-Puerta]]></surname>
<given-names><![CDATA[JA]]></given-names>
</name>
<name>
<surname><![CDATA[Peris]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[High prevalence of prothrombotic abnormalities in multifocal osteonecrosis]]></article-title>
<collab>Revertre J et al</collab>
<source><![CDATA[Medicine]]></source>
<year>2013</year>
<volume>92</volume>
<page-range>295-304</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Fajardo-Hermosillo]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Lopez]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Nadal]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Multifocal osteonecrosis in systemic lupus erythematosus: case report and review of the literature]]></article-title>
<source><![CDATA[BMJ Case Rep]]></source>
<year>2013</year>
</nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Gallart Ubeda]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Elia]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Puerta]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Osteonecrosis multifocal]]></article-title>
<source><![CDATA[Actualización y caso clínico.Rehabilitación (Madr)]]></source>
<year>2020</year>
<volume>54</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>63-7</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Reheman]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Taylor]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Multifocal Osteonecrosis - A Case Report]]></article-title>
<collab>Jhonson V et al</collab>
<source><![CDATA[Clin Rheumatol]]></source>
<year>2002</year>
<volume>21</volume>
<page-range>322-3</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Jeong]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Kim]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Cho]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Clinical characteristics of multifocal osteonecrosis in Korean patients with rheumatic disease International Journal of Rheumatic Diseases]]></article-title>
<source><![CDATA[Int J Rheum Dis]]></source>
<year>2018</year>
<volume>21</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>1301-8</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
