Geraard Spergen wrote:
> Tom Kunich wrote:
>
>> "Geraard Spergen" <[email protected]> wrote
>>
>>> He didn't invent it - it is very well documented, if not understood.
>
>
>>> Landis has been taking steroids for his hip, it's in his file and
>>> above the boards. Can't say that the steroids are the cause, but
>>> can't rule them out either.
>>
>>
>>
>> Let's clear this up - how many cases are caused by steroid abuse? Or
>> maybe you missed the part, "Corticosteroid injections — for instance,
>> into an inflamed or arthritic joint — don't cause avascular necrosis"?
>>
>>
> I didn't miss it, I only said that you can't rule it out and that your
> claim Patricio made it up was wrong. The Phonak doper bit was over the
> top but the steroid connection was not.
>
> Here's an easy to read research letter with some perspective.
> http://www.cmaj.ca/cgi/content/full/164/2/205
Am I missing something here? The study seems to say that they hunted
through their patients with damaged [osteonecrotic] hips to find those
15 who had taken steroids [prescribed for legit medical reasons]. And
guess what? All 15 had damaged hips, and they all had taken steroids!
The only explanation I can see is that they said they couldn't identify
other factors as the cause of the osteonecrosis.
Is it the case that in the vast majority of cases of osteonecrosis, a
clear cause is identifiable?
The study author *do* admit that:
"A potential criticism of our study is that the osteonecrosis seen in
our patients may have been either idiopathic or associated with some
other (as yet unknown) precipitating factor. Although this is possible,
we think that the number of cases [15 cases] in this series provides a
strong link between steroid administration and the subsequent
development of osteonecrosis in these patients."
I'm not a physician, and I only play a statistician in the classroom,
but this particular study seems pretty weak to me.
Mark