Ovarian bone necrosis (osteonecrosis) 4.5/5 (2)

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Avascular osteonecrosis

MRI examination: Avascular bone necrosis / osteonecrosis of the shoulder. Dr. Roberto Schubert, Radiopaedia.org. From the case rID: 16018

Definition

Avascular bone necrosis (osteonecrosis) causes bone tissue to die, most often in end portions of the bones (epiphyses), for example in the head of the femur towards the hip joint or down to the knees. The upper leg can be attacked by the shoulders. Also smaller bones in the feet, hands and vertebrae can be attacked.

  • The condition is also called aseptic or ischemic bone necrosis.

Disease Causes

Avascular bone necrosis is caused by low blood supply to the skeleton in various conditions:

Among children, avascular bone necrosis occurs at different locations (see list below), most commonly at the hip Legg-Calve-Perthes disease and epiphysiolysis (epiphysiolysis capitis femoris).

Symptoms of Avascular Bone Necrosis

Pain occurs early and is a typical symptom.

  • If the limb is close to the hip joint (most common location), the pain is often felt in the groin and pelvis, especially during strain and movement
Avascular necrosis

Avascular necrosis of the vertebrae (Kümmell's disease). Illustration: A.Prof Frank Gaillard, Radiopaedia.org, rID: 5354

Examinations

In early stages, the diagnosis can be difficult to set.

  • MRI however, often shows distinct changes in the skeleton
  • If the bone structure collapses, x-rays will also be useful, and clinical examination often shows reduced mobility

Diagnosis

Avascular bone necrosis is detected on the basis of symptoms and MRI in early stages. Later in the process, X-rays also show typical changes.

Various types of avascular bone necrosis

Own name list here

Shoulder

collarbone

Elbow

Wrist

  • Wrist (distal ulna)

Hand

Back Whirls

Hip

Pelvic

Knee

Ankle

Foot

Incorrect diagnosis (similar conditions, differential diagnoses)

Treatment

In the early stages it is recommended to relieve the affected area for example by using crutches and using painkillers or NSAIDs as required. Most people will still need surgery afterwards

  • In case of major joint injuries in the hips, knees or shoulders, insertion of a joint prosthesis is often chosen

Literature


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