RNPC3 and avascular necrosis: This is the first multi-center cohort study to investigate the predictors for AVN in Chinese SLE patients and found early disease onset of SLE, arthritis, existing organ damage (SDI≥1) at registration, positive anti-RNP, and high maximum daily dose of glucocorticoids as independent risk factors, and developed a risk scoring system, which can help stratify patients at high risk for AVN and facilitate clinical decision making for disease surveillance and intervention.