Multiple rib infarcts: a rare form of osteonecrosis in antiphospholipid syndrome

ON has obvious association with various systemic conditions, including sickle cell disease, prolonged glucocorticoid treatment, alcohol abuse, and Gaucher's disease, and several factors, such as vascular thrombosis, mechanical defects, cellular damage, embolisation, changes in intraosseous pressure, or trauma, have been proposed in its pathogenesis. 1 For rheumatological diseases, a pathogenic relationship between aPL and ON has been proposed on the basis of clinical observations of patients with APS who developed ON in the absence of glucocorticoid treatment. 2, 3 Several studies showed a correlation between aPL and ON in patients with systemic lupus erythematosus, 4- 6 and Belmonte et al 7 suggested a possible association of aPL with ON in patients with HIV infection. [...]owing to the hypercoagulable potential of aPL, vascular occlusion or thrombotic vasculopathy related to the aPL was also thought to be the underlying pathogenetic mechanism. [...]the prothrombotic potential of aPL and the above described clinical features of this patient suggest that aPL are directly implicated in the aetiopathogenesis of ON.