I am diagnosed with Avascular necrosis

Compliment of the season Doctor. I am experiencing pains in my right upper part of my leg, leading to little limping. I visited a doctor who after thorough investigation informed me I have Avascular necrosis (AVN) of the head of femur. Provide simple information to me. Becky from Lagos   Thanks Becky for your question, “Avascular […]

Compliment of the season Doctor. I am experiencing pains in my right upper part of my leg, leading to little limping. I visited a doctor who after thorough investigation informed me I have Avascular necrosis (AVN) of the head of femur. Provide simple information to me. Becky from Lagos  

Thanks Becky for your question, “Avascular necrosis (AVN), also called osteonecrosis, aseptic necrosis, or ischemic bone necrosis, is a condition that occurs when there is loss of blood to the bone. Because bone is living tissue that requires blood, an interruption to the blood supply causes bone to die. Avascular necrosis is the death of bone tissue due to a lack of blood supply. And can lead to tiny breaks in the bone and the bone’s eventual collapse.”

Anyone can be affected by avascular necrosis. However, it’s most common in people between the ages of 30 and 60. Because of this relatively young age range, avascular necrosis can have significant long-term consequences. Pain can be mild or severe and usually develops gradually. 

Some Causes

1.      Avascular necrosis occurs when blood flow to a bone is interrupted or reduced. Reduced blood supply can be caused by:

2.      Joint or bone trauma. An injury, such as a dislocated joint, might damage nearby blood vessels. 

3.      Cancer treatments involving radiation also can weaken bone and harm blood vessels.

4. Fatty deposits in blood vessels. The fat (lipids) can block small blood vessels, reducing the blood flow that feeds bones.

5.  Certain diseases. Medical conditions, such as sickle cell anemia and Gaucher’s disease, also can cause diminished blood flow to bone.

6.      For about 25 percent of people with avascular necrosis, the cause of interrupted blood flow is unknown.

Some Risk factors

Risk factors for developing avascular necrosis include:

1.      Trauma. Injuries, such as hip dislocation or fracture, can damage nearby blood vessels and reduce blood flow to bones.

2.      Steroid use. High-dose use of corticosteroids is the most common cause of avascular necrosis that isn’t related to trauma. 

3. Excessive alcohol use. Consuming several alcoholic drinks a day for several years also can cause fatty deposits to form in your blood vessels.

4.      Certain medical treatments. Radiation therapy for cancer can weaken bone. Organ transplantation, especially kidney transplant, also is associated with avascular necrosis.

5.      Medical conditions associated with avascular necrosis include: pancreatitis, diabetes, HIV/AIDS and Sickle cell anemia.

Complications

Untreated, avascular necrosis worsens with time. Eventually the bone may become so weakened that it collapses. Avascular necrosis also causes bone to lose its smooth shape, potentially leading to severe arthritis

Tests and diagnosis

1.      Imaging tests

2.      Many disorders can cause joint pain. Imaging tests can help pinpoint the source of pain. The options include:

3.      X-rays which reveals bone changes that occur in the later stages of avascular necrosis. 

4.      MRI and CT scan. These tests produce detailed images that can show early changes in bone that may indicate avascular necrosis.

5.      Bone scan. 

Medications and therapy

The goal is to prevent further bone loss. Specific treatment usually depends on the amount of bone damage one has.

In the early stages of avascular necrosis, symptoms can be reduced with medication and therapy.

1. Nonsteroidal anti-inflammatory drugs. 

2.      Osteoporosis drugs. 

3.      Cholesterol-lowering drugs. 

4.      Blood thinners. 

5.      Rest. Reducing the weight and stress on affected bone can slow the damage. 

6.      Exercises with doctor’s advice will help a lot.

Surgical and other procedures

Because most people don’t start having symptoms until avascular necrosis is fairly advanced, doctor may recommend surgery. The options include:

1.      Core decompression. The surgeon removes part of the inner layer of the bone. 

2.      Bone transplant (graft). This procedure can help strengthen the area of bone affected by avascular necrosis. 

3.      Bone reshaping (osteotomy). 

4.      Joint replacement. 

Prevention

1.      To reduce risk of avascular necrosis and improve general health:

2.      Limit alcohol. Heavy drinking is one of the top risk factors for developing avascular necrosis.

3.      Keep cholesterol levels low. Tiny bits of fat are the most common substance blocking blood supply to bones.

4.      Monitor steroid use.