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Avascular Bone Necrosis

George X. Trimble, M.D.
JAMA. 1961;175(10):923. doi:10.1001/jama.1961.03040100087025.
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To the Editor:—  The contribution by Dr. E. Dubois, "Avascular Bone Necrosis Associated with Systemic Lupus Erythematosus," in The Journal, Oct. 22, 1960, page 966, is timely, since femoral head necrosis has been the topic of a number of very recent publications.Some months ago Dr. D. Polhemus, attending physician at the Los Angeles Children's Hospital, informed me that he had noted in children an association between avascular necrosis of the femoral head and systemic lupus erythematosus (S.L.E.). He mentioned, too, similar observations by Doctor Dubois in adults at Los Angeles County General Hospital, which are referred to briefly in an earlier report in The Journal, Aug. 13, 1960, page 1633. As a result, I reviewed some of the pertinent information available to me.In his article, previously mentioned, Dubois states that "aseptic necrosis of the bone has never been described heretofore in S.L.E. or rheumatoid arthritis, a closely related


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