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Also called: Aseptic necrosis, Avascular necrosis, Ischemic necrosis

Osteonecrosis is a disease caused by reduced blood flow to bones in the joints. In people with healthy bones, new bone is always replacing old bone. In osteonecrosis, the lack of blood causes the bone to break down faster than the body can make enough new bone. The bone starts to die and may break down.

You can have osteonecrosis in one or several bones. It is most common in the upper leg. Other common sites are your upper arm and your knees, shoulders and ankles. The disease can affect men and women of any age, but it usually strikes in your thirties, forties or fifties.

At first, you might not have any symptoms. As the disease gets worse, you will probably have joint pain that becomes more severe. You may not be able to bend or move the affected joint very well.

No one is sure what causes the disease. Risk factors include

  • Long-term steroid treatment
  • Alcohol abuse
  • Joint injuries
  • Having certain diseases, including arthritis and cancer

Doctors use imaging tests and other tests to diagnose osteonecrosis. Treatments include medicines, using crutches, limiting activities that put weight on the affected joints, electrical stimulation and surgery.

NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases

Symptoms of Osteonecrosis

The following features are indicative of Osteonecrosis:
  • joint pain
  • pain that occurs even at rest
  • limited range of motion
  • groin pain
  • limping
It is possible that Osteonecrosis shows no physical symptoms and still be present in a patient.

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Common Causes of Osteonecrosis

The following are the most common causes of Osteonecrosis:
  • reduced blood supply in bone tissues
  • joint trauma
  • bone trauma
  • fatty deposits in blood vessels
  • Gaucher's disease

Risk Factors for Osteonecrosis

The following factors may increase the likelihood of Osteonecrosis:
  • trauma
  • steroid use
  • excessive alcohol use
  • bisphosphonate use

Prevention of Osteonecrosis

Yes, it may be possible to prevent Osteonecrosis. Prevention may be possible by doing the following:
  • avoid high doses and long-term use of corticosteroids
  • do not drink excessive amounts of alcohol

Occurrence of Osteonecrosis

Number of Cases

The following are the number of Osteonecrosis cases seen each year worldwide:
  • Rare between 10K - 50K cases

Common Age Group

Osteonecrosis can occur at any age.

Common Gender

Osteonecrosis can occur in any gender.

Lab Tests and Procedures for Diagnosis of Osteonecrosis

The following lab tests and procedures are used to detect Osteonecrosis:
  • Physical exam: To determine the tenderness around your joints
  • X-rays: To evaluate the bone changes that occur in the later stages of avascular necrosis
  • Magnetic resonance imaging and Computerized tomography scan: To view the early changes in bone that may indicate avascular necrosis
  • Bone scan: To diagnose the avascular necrosis

Doctor for Diagnosis of Osteonecrosis

Patients should visit the following specialists if they have symptoms of Osteonecrosis:
  • Rheumatologist
  • Orthopedic surgeon

Complications of Osteonecrosis if untreated

Yes, Osteonecrosis causes complications if it is not treated. Below is the list of complications and problems that may arise if Osteonecrosis is left untreated:
  • severe arthritis
  • limited movement

Procedures for Treatment of Osteonecrosis

The following procedures are used to treat Osteonecrosis:
  • Core decompression: Activates the production of healthy bone tissue and new blood vessels
  • Bone transplant: Strengthens the area of bone affected by avascular necrosis
  • Bone reshaping: Allows you to postpone joint replacement
  • Joint replacement: Replaces the damaged parts of your joint with plastic or metal parts

Self-care for Osteonecrosis

The following self-care actions or lifestyle changes may help in the treatment or management of Osteonecrosis:
  • Regular exercise: Helps in maintaining or improving the range of motion in your joint
  • Take proper rest: Decreasing the weight and stress on your affected bone can lower the damage

Patient Support for Treatment of Osteonecrosis

The following actions may help Osteonecrosis patients:
  • Join support organizations: Provides you more detailed information to treat the osteonecrosis

Time for Treatment of Osteonecrosis

While time-period of treatment for each patient may vary, below is the typical time-period for Osteonecrosis to resolve if treated properly under an expert supervision:
  • Disease cannot be treated but only maintained or effects reduced

Last updated date

This page was last updated on 2/04/2019.
This page provides information for Osteonecrosis.
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