Avascular necrosis

The most common joints affected by avascular necrosis is hip. Avascular necrosis worse with time, so management is a long process.

Define

Avascular necrosis of the bone tissue dies due to lack of blood supply. Also known as osteonecrosis, avascular necrosis can lead to broken bones and small in the end is the collapse of bone.


Blood flow to a part of the bone may be interrupted if a broken bone or dislocated joints. Avascular necrosis is associated with prolonged use of high doses of steroids and excessive drinking.

The most common joints affected by avascular necrosis is hip. Avascular necrosis worse with time, so management is a long process.

The symptoms

Avascular necrosis usually cause pain and decreased range of motion affected joint. The joints most commonly affected by avascular necrosis include:

Hip. Also in the hip joint pain, pain can also spread to the groin or thigh to the knee goes down.

Knees. Avascular necrosis knee, pain occurs most often on the inside of the knees and worse with activity.

Scapula. Some come in the shoulder, but the most common is affected by avascular necrosis of the upper arm bone.

Some people have bilateral avascular necrosis - for example, in both hips or both knees. These signs and symptoms may appear suddenly caused by an injury. In other cases, the pain and stiffness can build up slowly over several months. Some people with avascular necrosis is not the full experience symptoms.

The other joints affected by avascular necrosis include:

Ankle.

Feet.

Hand.

Ham.

Spine.

Wrists.

See your doctor if you have persistent pain in any joint public. Seek medical attention immediately if you believe that there is a broken bone or dislocated.

Cause

Avascular necrosis occurs when blood flow to the bone interruption or reduction, can be caused by:

Injury. The impact that results broken or dislocated bones can also damage or destroy the blood vessels nearby. Without a steady supply of oxygen and nutrients, bone cells die.

Narrowing of blood vessels. Blood Flow to the bone can be reduced if the bone blood flow by arterial narrowing or blockages, most often a little bit of fat - the volume of red blood cells deformed - in schools with sickle cell anemia.

The pressure inside the bone. Some medical treatments or conditions, such as Legg-Calve-Perthes disease or Gaucher disease, can increase the pressure inside the bone, making it more difficult for blood to penetrate .

The risk factors

Two common risk factors of avascular necrosis is:

Corticosteroids. Those high doses of corticosteroids such as prednisone, for a long time - for example, those with chronic diseases such as rheumatoid arthritis and lupus - are more likely to be avascular necrosis.

Heavy drinking. Some drink alcohol every day for many years can cause the formation of fat in the bloodstream. This can restrict the flow of blood to the bone. The alcohol concentrations above the daily consumption, the higher the risk of avascular necrosis.

Osteoporosis medications can harm the function

People taking bisphosphonates, a drug used to help strengthen bones weakened by osteoporosis - sometimes develop osteonecrosis of the jaw. This risk is higher for people who took high doses of intravenous bisphosphonates against the damage caused by bone cancer.

The procedure may increase the risk of

Some types of medical procedures can weaken the bones, making it easier to develop avascular necrosis. Examples include:

Cancer treatments such as chemotherapy or radiotherapy.

Dialysis, a process to clean up the blood when kidney failure.

Kidney and other organ transplants.

Conditions related to bone death

Many underlying medical conditions increase the risk of developing avascular necrosis. These include:

Diabetes.

Gaucher disease.

HIV.

Kienbock disease.

Legg-Calve-Perthes disease.

Lupus.

Anaemia.

Complications

Avascular necrosis is not treated will continue to cause bone deterioration. Finally, bones can become weakened enough for it to collapse, causing pain and disability. To avascular necrosis untreated can lead to severe pain and loss within 2-5 years.

Tests and diagnosis

Many disorders can cause joint pain. Check images can help determine the appropriate diagnosis.

X optics. In the early stages of avascular necrosis, X-rays are usually normal appearance. However, X-rays can often reveal bone changes occur in the later stages of the disease.

Magnetic resonance imaging (MRI). MRI scans can show early changes in bone might be signs of avascular necrosis. MRI uses radio waves and a strong magnetic field to produce detailed images of internal structures.

Bone Scan. For bone scan, a small amount of radioactive substance is injected into a vein. This material then go to the part of the bone injury or disease, and is highlighted on the image.

Treatments and drugs

The goal of treatment for avascular necrosis is to prevent further bone loss. Treatment received depends on the amount of bone loss has. The first phase of avascular necrosis may benefit from conservative treatment, whereas later stages may require surgery.

Drug

Non-steroidal anti-inflammatory drug (NSAID). NSAIDs, such as aspirin or ibuprofen (Advil, Motrin, others), may help reduce the pain and inflammation associated with avascular necrosis.

Bisphosphonates. Some studies indicate that osteoporosis drugs, such as alendronate (Fosamax), may slow the progression of avascular necrosis.

Treatment

Rest. Reduce weight and stress on the affected bone may slow down damage caused by avascular necrosis. You may need to limit the amount of physical activity participation. In the case of the hip or knee avascular necrosis, may need to use crutches to lose weight to fit in a few months.

Exercises. Some exercises can help maintain or improve range of motion in joints. Physical therapy can choose specific exercises to condition and how to teach.

Electrical stimulation. The current can encourage the body to develop new bone to replace the damaged area due to avascular necrosis. Electrical stimulation can be used during surgery and applied directly to the injured area. Or it can be managed through electrodes attached to the skin.

Surgery and other procedures

Phas bone compression. In this operation, surgeons removed a portion of the inner layer of bone. This can reduce the pressure in the bone pain. More space allows bone formation of new blood vessels and stimulates the production of new bone.

Transplantation of bone. In this procedure, surgeons take healthy bone from another part of the body and transplanted it into the area affected by avascular necrosis. Sometimes this is done in combination with decompression.

Reshape the bone (osteotomy). This procedure, the shape of bone to reduce the amount of stress placed on the area affected by avascular necrosis. Osteotomy is often used in people with avascular necrosis progresses. Recovery may take up to a year.

Replace. If bone disease has collapsed or other treatment options are not satisfactory, may require joint replacement surgery. Joint replacement surgery, joint replacement with an artificial joint. It requires months of recovery, including time learning to use new joints.