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Four patients with Behçet's disease (a 42-year-old woman and 3 men aged 24, 32 and 39 respectively), who had received high doses of prednisone (0.5 to 1 mg/kg/day) during a mean period of 21 months developed aseptic osteonecrosis of the femoral heads and condyles which obliged to reduce steroid dosage and to introduce additional drugs. Corticosteroids are useful in Behçet's disease, as in other systemic diseases, but they probably act also on the underlying immune vascularitis. The occurrence of pain in weight-bearing joints during treatment should suggest osteonecrosis and in such cases, beside radiography, scintigraphy with technetium and/or phlebography with pressure measurement might provide an early diagnosis.
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