Ibd patient on prednisone for 4 mos mri now shows osteonecrosis is this reversible or how is it treated now off prednisone will it continue worsening?

Varies: It varies quite a bit, avascular necrosis, like the name implies, involves a loss in blood flow to the bone leading to necrosis (death) of some of the bone cells, this is usually followed by an attempt by the bone to repair itself. The clinical outcomes in avn vary tremendously, with some people having minimal problems and others having complete collapse of the bone and needing hip replacement.

It is not reversible: Osteonecrosis actually denotes death of bone. It is not uncommon that with prolonged cortisone use osteonecrosis of bone may occur it is most often seen in the hip. Once it develops it is not reversible. It often leads to chronic pain and may ultimately cause painful arthritis. In its end stages joint replacement may be needed.