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OSTEONECROSIS

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OSTEONECROSIS

Osteonecrosis also called avascular necrosis, or bone infarction is a condition that results from an interruption of blood supply to the bone.

  • The bone is a living tissue that requires blood, a lack of blood flow to the bone can lead to the death of bone tissue. If not treated, it can eventually cause the bone to collapse.
  • The condition also causes the bone to lose its smooth shape, leading to severe arthritis.
  • The most commonly affected joint is the hip bone but other common sites are the knees, shoulder, and
  • Estimate has shown that as many as 20,000 people develop the condition annually.
  • Anyone can be affected, but osteonecrosis is most prevalent in people between the ages of 20 and 50.

CAUSES

Osteonecrosis often results from an underlying health condition or injury. Healthy people have a lower risk of developing the condition. Possible cause of may include:

  • Dislocation or fracture of the thigh bone.
  • Long-term use of corticosteroids such as prednisone.
  • Dislocated joint
  • Alcoholism
  • Blood clots, inflammation, and damage to arteries
  • Chemotherapy or radiation therapy
  • Organ transplant, especially kidney transplants

Medical conditions that cause the condition may include:

  • Autoimmune diseases
  • Diabetes
  • HIV/AIDS
  • Gaucher’s disease
  • Sickle cell anemia or other blood conditions
  • Pancreatitis

SYMPTOMS

In the early stage of the condition, many people have no symptoms but as the disease progresses, symptoms may occur and may include:

  • Mild or severe pain in the affected region
  • Pain that occurs when you put weight on the affected bone
  • Severe pain that interferes with an ability to use the joints or move.

DIAGNOSIS AND TREATMENT

 

DIAGNOSIS

During a physical examination, your doctor will likely check your joints for tenderness. The joint may also be moved through different positions to see if your range of motion has decreased. To get a proper look at your bones, one or more imaging test may be recommended.

  • X-rays- X-rays usually appear normal in the early stage but can reveal changes to the bone that occur in the later stage of the condition.
  • MRI or CT scan- This type of imaging can show early changes in your bone and can help the doctor to see how much of the bone is affected.
  • Bone scan- This type of scan requires that your doctor insert a small amount of harmless radioactive substance into your vein. This substance lets the doctor see the inside of your bone.
TREATMENT

The aim of the treatment is to improve the function of the affected bone, prevent other bone loss and reduce pain. There are some factors that determine the kind of treatment that you are given, they are

  • Age
  • The cause
  • Amount of bone damage and its location

If the cause of the disease is identified, treating the underlying medical conditions may be necessary.

In the early stage, medication and therapy may be needed to relieve symptoms. Your doctor may recommend:

Blood thinners such as warfarin may be prescribed to dissolve clots If your osteonecrosis is caused by blood clots.

Anti-inflammatory medications may be prescribed if your condition is caused by an inflammation of the arteries.

Reducing pressure and stress on the affected bone. This can slow down the damage. This may be achieved by using crutches and can be used if your hip, ankle, or knee is affected.

Exercises to improve the range of motion in your joint.

Electrical stimulations to help your body to grow new bones to replace the damaged ones.

If your condition is at the later stage, surgery may be recommended and may include:

Bone grafts, bone reshaping, total joint replacement and core depression.