All conditions

Bone & joint

Avascular Necrosis

Also known as: Osteonecrosis

Death of bone tissue caused by a loss of blood supply, most often in the hip, which can lead to collapse of the joint.

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Avascular Necrosis
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What it is

When blood flow to a section of bone is interrupted, the bone cells die and the area weakens. The hip is most common, followed by the knee, shoulder and ankle. Major risk factors are high-dose steroid use, heavy alcohol use, injury, sickle cell disease and lupus.

Symptoms

Early on there may be none. Later comes a deep groin, thigh or buttock ache that worsens with weight bearing and eventually at rest, with limited range of motion.

How it’s diagnosed

MRI is the most sensitive test and can detect early changes before X-rays. X-rays show later flattening or collapse of the bone.

Treatment

Early stages may be managed with protected weight bearing, pain relief and addressing risk factors. Surgery such as core decompression can help early disease, and joint replacement is used when the bone has collapsed.

Living with it

Limit alcohol and use the lowest effective steroid dose. Report new hip pain promptly if you have taken high-dose steroids.

At a glance

Category

Bone & joint

Also known as

Osteonecrosis

Reviewed by Farhan Tahir, MD, FACR

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