All of them. Virtually all bones can get avn (avascular necrosis). Usually avn occurs at the ends of bones, at the joint.
Shoulder and hip. The two most affected are the proximal humerus (shoulder) and the femoral head (hip). Other possible sites include the medial femoral condyle (knee) or the talus (ankle), especially after a traumatic injury.
Let me explain. Avascular necrosis (and avn) is a disease where there is cellular death (necrosis) of bone components due to interruption of the blood supply.] without blood, the bone tissue dies and the bone collapses. If avascular necrosis involves the bones of a joint, it often leads to destruction of the bone, the bone will there but deformed.
Cysts in bone. Cystic changes or erosions in bone post trauma can indicate that the bone matrix was disrupted from the injury and cystic changes have resulted. It does not mean that you have avascular necrosis, but it can mean that there are changes in the trabecular patterns of the bone due to the trauma. Bone injuries can cause many different bone patterns to occur as a result of the bone trying to heal itsel.
Possible. Possible but highly unlikely.
At times. Its possible.
The ends of. The long bones have the most tenuous blood supply, and thus are at the greatest risk.
Not only long bones. Sickle cell avn can occur in any bone that has limited blood supply. The obstruction to blood flow caused by sickle cells can cause the bone to die and distort normal shape and function, causing pain. The head of the femur (a long bone) and the talus bone (not long bone) in the ankle are common sites of avn in my sickle cell patients.
Whatever works. That was a terse answer, but that is the truth. Everything from over the counter meds to narcotics need to be used, but most people will eventually need narcotics due to the intense pain. Bisphosphonates are used to slow the damage, but does not alleviate the pain. Surgery is the definitive solution.
I'm 25 with avascular necrosis (bilateral) and I don't have lupus, sickle cell disease, never used steroid medication, nor never injury a bone! Reason?
ETOH? Trauma is a common cause. Steroid use & etoh abuse are next. Heredity and other diseases can cause it as well. Otherwise it is idiopathic.
Can nicotine cause avascular necrosis as it constricts blood vessels? I know it stopped my recent bone graft in a spinal fusion from growing properly.
Yes, excellent questn. You are very perceptive. There is a tremendous concern that smoking could cause this although more common causes include the use of steroids, traumatic injury and excessive alcohol.
Maybe. Smoking is well-known to impair new blood vessel growth into areas of bone fusion and prevent good healing. There are thousands of chemicals in smoke. Nicotine alone has been well studied and tends to show poor bone formation and mineralization. So using nicotine as a supplement instead of smoking still is a risk for your spinal fusion. You have one spine -- take good care! Good Luck!