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Definition

What is avascular necrosis?

Avascular necrosis is the death of bone tissue because of a lack of blood supply. It is also called osteonecrosis, and avascular necrosis can lead to tiny breaks in the bone and the bone’s eventual collapse. The blood flow to a section of bone can be interrupted if the bone is fractured or the joint becomes dislocated. Avascular necrosis is also related to long-term use of high-dose steroid medications and excessive alcohol intake. 

How common is avascular necrosis?

Anyone can be affected by avascular necrosis. However, it is more popular in people between the ages of 30 and 60. Due to this relatively young age range, avascular necrosis can have significant long-term consequences.

However, it can be managed by reducing your risk factors. Please discuss with your doctor for further information.

Symptoms

What are the symptoms of avascular necrosis?

Many individuals experience no symptoms in the early stages of avascular necrosis. As the condition becomes worse, your affected joint may hurt only when you put weight on it. Eventually, the joint may hurt even when you are lying down.

Moreover, pain can range from mild to severe and usually develops gradually. Pain associated with avascular necrosis of the hip may be focused in the groin, thigh or buttock. In addition to the hip, the areas likely to be affected are the shoulder, knee, hand and foot.

Some people increase avascular necrosis bilaterally — for example, in both hips or in both knees.

When should I see my doctor?

See your doctor if you have persistent pain in any joint. Seek immediate medical attention if you believe you have a broken bone or a dislocated joint.

Causes

What causes avascular necrosis?

It is proven that avascular necrosis happens as blood flow to a bone is interrupted or reduced. And reduced blood supply can be caused by some following conditions:

Joint or bone trauma

An injury, such as a dislocated joint, might damage nearby blood vessels. Cancer treatments involving radiation also can weaken bone and harm blood vessels.

Fatty deposits in blood vessel

The fat (lipids) can block small blood vessels, reducing the blood flow that feeds bones.

Certain diseases

Medical conditions, such as sickle cell anemia and Gaucher’s disease, also can cause diminished blood flow to bone.

However, for about 25 percent of people with avascular necrosis, the cause of interrupted blood flow is unknown.

Risk factors

What increases my risk for avascular necrosis?

There are a great number of risk factors engendering avascular necrosis. These following risks are considered as the most common ones including:

Trauma

Injuries, such as hip dislocation or fracture, can damage nearby blood vessels and reduce blood flow to bones.

Steroid use

High-dose use of corticosteroids, such as prednisone, is the most common cause of avascular necrosis that isn’t related to trauma. The exact reason is unknown, but one hypothesis is that corticosteroids can increase lipid levels in your blood, reducing blood flow and leading to avascular necrosis.

Excessive alcohol use

Consuming several alcoholic drinks a day for several years also can cause fatty deposits to form in your blood vessels.

Bisphosphonate use

Long-term use of medications to increase bone density may be a risk factor for developing osteonecrosis of the jaw. This complication has occurred in some people treated with these medications for cancers, such as multiple myeloma and metastatic breast cancer. The risk appears to be lower for women treated with bisphosphonates for osteoporosis.

Certain medical treatments

Radiation therapy for cancer can weaken bone. Organ transplantation, especially kidney transplant, also is associated with avascular necrosis.

Besides, some medical conditions related to avascular necrosis may include:

  • Pancreatitis
  • Diabetes
  • Gaucher’s disease
  • HIV/AIDS
  • Systemic lupus erythematosus
  • Sickle cell anemia

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is avascular necrosis diagnosed?

If your doctor suspects that you may experience this condition, a physical examination will be performed and some tests will be also recommended by your doctor. During a physical exam your doctor will likely press around your joints, checking for tenderness. Your doctor also moves the joints through a variety of positions to see if your range of motion has been reduced. Tests and procedures used to diagnose avascular necrosis may include:

X-rays

They can reveal bone changes that occur in the later stages of avascular necrosis. In the condition’s early stages, X-rays usually appear normal.

MRI and CT scan

These tests produce detailed images that can show early changes in bone that may indicate avascular necrosis.

Bone scan

A small amount of radioactive material is injected into your vein. This tracer travels to the parts of your bones that are injured or healing and shows up as bright spots on the imaging plate.

How is avascular necrosis treated?

Doctors usually start with treatments to limit further damage to the bone and joint and to help the bone to grow. Treatments may include medicines, exercises, and electrical stimulation as well as limiting weight-bearing on the joint. Anti-inflammatory drugs (NSAIDs) may be prescribed to reduce pain. Eventually, most people with avascular necrosis need surgery.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage avascular necrosis?

To reduce your risk of avascular necrosis and improve your general health:

  • Limit alcohol: Heavy drinking is one of the top risk factors for developing avascular necrosis.
  • Keep cholesterol levels low: Tiny bits of fat are the most common substance blocking blood supply to bones.
  • Monitor steroid use: Make sure your doctor knows about any past or present use of high-dose steroids. Steroid-related bone damage appears to worsen with repeated courses of high-dose steroids.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: July 11, 2017 | Last Modified: July 11, 2017

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