Avascular necrosis of the metacarpals in juvenile dermatomyositis.

Avascular necrosis (AVN) of the metacarpal heads is uncommon and has been associated with trauma, systemic lupus erythematosus, and corticosteroid usage. There have been no previous reports of metacarpal AVN described in patients with juvenile dermatomyositis. Descriptions of AVN in juvenile dermatomyositis are rare. We present 2 cases of patients with juvenile dermatomyositis who developed multifocal avascular necrosis after corticosteroid therapy with unusual distribution and review the literature on metacarpal AVN.