Avascular Necrosis

Danielle Dietz

Summary

Avascular Necrosis is the death of bone tissue due to a lack of blood supply. This disorder which is also called osteonecrosis, leads to tiny breaks in the bone and the bone's eventual collapse. AN occurs when the blood flow to a bone is interrupted or reduced, which may be caused by joint or bone injury or even pressure inside the bone. Some of the causes of AN are associated with long term use of high-dose steroid medications and excessive alcohol intake. Osteonecrosis can happen to anyone, but it usually occurs in men between the ages of 30 and 60.

Body Parts

  • Hip, wrist, weakness in fingers, pain and stiffness in upper arms, pain in lower end of thigh bone, shoulders, feet.
  • Patella, carpals (carpals, metacarpals, and phalanges), tarsals (tarsals, metatarsals, and phalanges), humerous, and femur.

Signs and Symptoms

Many people have no symptoms in the early stages of AN of bone. As the disease worsens, joints may hurt with weight put on it, or even when laying down. Pain can be mild or severe. The joints affected are the patella, humerous, scapula, coxa, carpals, and tarsals. If persistent pain is in one of those affected joints you should see a doctor. Immediate medical attention if you have a broken bone or a dislocated joint.

Tests/Diagnostic Workup

An exam will be conducted by pressing around the joint, checking for tenderness, moving the joints in a variety of positions (to see if range of motion has been reduced). X-rays, bone scans, magnetic resonance imaging (MRI), biopsy, and computed tomography scan (CT) will be preformed to test for Avascular Necrosis.

Treatment/Prognosis

  • For medications: non steroidal anti-inflammatory drugs (NSAIDs), osteoporosis drugs, cholesterol drugs , and blood thinners
  • For therapy/early stages: rest, electrical stimulation, and exercise.
  • For surgery: core decompression, bone transplant (graft), bone reshaping (osteotomy), joint replacement, and arthroplasty/total joint replacement. Prevention- limit alcohol, keep cholesterol levels low, and monitor steroid use

Statistics

Avascular Necrosis affects 10,000 to 20,000 people in the USA each year. This disorder is considered a "rare disease" and affects less than 200,000 people in the US population.

Citations

  • "Avascular Necrosis."Complications.N.p.,n.d. Web.02 Dec.2014
  • "Avascular Necrosis."Cleveland Clinic.N.p.,n.d. Web.02 Dec.2014