Doctor insights on:
What Does Avascular Necrosis Feel Like
Avascular necrosis: Bone is a living tissue that is constantly turning over; this involves tightly regulated systems of bone addition and subtraction. In order to deliver the cells that are responsible there needs to be adequate blood flow. If the blood flow is disrupted significantly, the affected areas can undergo avascular necrosis (avn). Avn can lead to collapse of the area and arthritis if it occurs near joints. ...Read more
Yes: Avascular necrosis is bone death due to lack of blood supply. This can occur in joints where the blood supply can be easily disrupted by injury or disease. Joints such as the hip, knee, wrist, elbow or ankle. Some medications such as steroids can increase risk of this problem. Disease which have increased risk include diabetes, sickle cell disease, gout, atherosclerosis. ...Read more
AVN: More information needed. In some bones (humeral + femoral head) if diagnosed before collapse and arthritis begins, there may be some value to core decompression. Some centers have shown decreased progression of collapse with free vascular fibula grafting (hip). No consensus regarding treatment before collapse. Once collapse occurs, some sort of resurfacing/replacement required to manage pain. ...Read more
No: If avascular necrosis (avn) has occurred, then part of the bone is dead (necrosis) and there is no cure. There are many causes from lupus to sickle cell disease to corticosteroids to alcohol abuse. The key is to prevent further avn by addressing the cause: treatment of alcoholism, reducing load (obesity) on the damaged bone, reducing the need for steroids, etc. ...Read more
What joint: You don't say what joint and what drugs you have taken or are on. The correct person to handle aseptic necrosis is an Ortopedic surgeon. ...Read more
See an MD: Avascular necrosis is the death of a joint due to disturbance of the blood supply. By far the most common is the hip joint and it mostly occurs as a side effect of long term, high dose steroid but also due to trauma to the joint. This is a serious problem, with significant joint pain and malfunction. Your brother has probably seen an orthopedic surgeon who can advise him about options. ...Read more
Not enough info: The risk really depend if you have a disease or take meds that predispose to the disease or have fractured a hip or are a diver for instance. If you do not take prednisone, do not drink alcohol to excess and have none of the diseases or injuries or activities associated with higher risk then your risk is virtually zero. ...Read more
Options limited: Depends on the location and manner of fracture. Shoulder & hips at highest risk for avascular bone necrosis, so only real prevention is not getting injured to begin with. In some special cases you can take steps to reduce risk. Deep sea divers (due to the bends) and patients on high dose long term corticosteroids are more at risk. Talk to your dr. ...Read more
Yes: You need to see an orthopedic surgeon. ...Read more
Hip joint breakdown: Avascular necrosis represents a spectrum of issues that advance from mild hip pain early in the process and heads toward varying degrees of femoral head collapse and severe pain with limited function. Speak to your orthopaedic surgeon if you are having progressive hip pain to see if imaging with X-rays or an MRI is indicated ...Read more
Yes: This is a known complication of taking steroids, especially if you had to take prolonged courses during your chemo regimen (for acute lymphoblastic leukemia, for example). Depending on the location and extent, treatment ranges from physical therapy and waiting, to some orthopedic surgery procedures. If you are still on steroids, you and your oncologist will have the risk/benefit ratio of stopping. ...Read more
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