Avascular necrosis is the death of bone tissue due to a lack of blood supply. Also called osteonecrosis, it can lead to tiny breaks in the bone and the bone's eventual collapse.
A broken bone or dislocated joint can interrupt the blood flow to a section of bone. Avascular necrosis is also associated with long-term use of high-dose steroid medications and excessive alcohol intake.
Anyone can be affected, but the condition is most common in people between the ages of 30 and 50.
Many people have no symptoms in the early stages of avascular necrosis. As the condition worsens, your affected joint might hurt only when you put weight on it. Eventually, you might feel the pain even when you're lying down.
Pain can be mild or severe and usually develops gradually. Pain associated with avascular necrosis of the hip might center on the groin, thigh or buttock. Besides the hip, the areas likely to be affected are the shoulder, knee, hand and foot.
Some people develop avascular necrosis on both sides (bilaterally) — such as in both hips or in both knees.
See your doctor if you have persistent pain in any joint. Seek immediate medical attention if you believe you have a broken bone or a dislocated joint.
Avascular necrosis occurs when blood flow to a bone is interrupted or reduced. Reduced blood supply can be caused by:
For about 25 percent of people with avascular necrosis, the cause of interrupted blood flow is unknown.
Risk factors for developing avascular necrosis include:
Medical conditions associated with avascular necrosis include:
Untreated, avascular necrosis worsens with time. Eventually, the bone can collapse. Avascular necrosis also causes bone to lose its smooth shape, potentially leading to severe arthritis.
To reduce your risk of avascular necrosis and improve your general health:
During a physical exam your doctor will likely press around your joints, checking for tenderness. Your doctor might also move the joints through a variety of positions to see if your range of motion has been reduced.
Many disorders can cause joint pain. Imaging tests can help pinpoint the source of pain. Options include:
The goal is to prevent further bone loss.
In the early stages of avascular necrosis, symptoms might be eased with medication and therapy. Your doctor might recommend:
Because most people don't develop symptoms until avascular necrosis is fairly advanced, your doctor might recommend surgery. The options include:
Your family doctor might refer you to a doctor who specializes in disorders of the joints (rheumatologist) or to an orthopedic surgeon.
Make a list of:
Ask a relative or friend to accompany you, if possible, to help you remember the information you receive.
Some questions to ask your doctor about avascular necrosis include:
Don't hesitate to ask other questions.
Your doctor is likely to ask you questions, including: