Osteonecrosis is strongly associated with systemic lupus erythematosus. The hip, and in particular the femoral head, is the most commonly encountered type. Glucocorticoids as well as disease associated factors have been proposed to enhance the risk for osteonecrosis development. This study aims to evaluate haemodynamic changes in the femoral head in patients with SLE before the development of osteonecrosis and determine the effect of the various risk factors of osteonecrosis on haemodynamic flow. This study was conducted on fourty consecutive female patients with systemic lupus erythematosus and twenty healthy volunteers, whom underwent clinical assessment, laboratory investigations as well as colour & power doppler ultrasound of the blood vessels (medial & lateral circumflex femoral arteries) supplying the femoral head bilaterally. From this study we concluded that hemodynamic flow to the hip is already altered in SLE patients without ON, and the presence of associated risk factors of ON contribute to more haemodynamic flow alteration.