Understanding Avascular Necrosis (AVN): Causes, Symptoms, and Management

What is it?

Avascular necrosis (AVN) is death of bone tissue that occurs due to interruption to the blood supply. Blood flow can be interrupted in cases of dislocated joints or a broken bone. Other conditions that can lead to AVN are alcohol misuse, bisphosphonate use, cancer radiation treatment, fatty deposits in blood vessels, or steroidal medication. Certain diseases such as sickle cell anemia, diabetes, HIV, lupus and Gaucher’s disease can be the primary cause for AVN. It is more common in people between the ages of 30-50. Joints that are affected from this condition are the hip joint, shoulder, knee, hand and foot. If left untreated, AVN worsens and eventually can cause bone collapse and arthritis.

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Additional names

This group contains additional names:
- Aseptic necrosis of bone

Signs & symptoms

At first, avascular necrosis does not cause any symptoms. Then, pain may begin when putting on weight on the affected joint. If the condition is not treated, the joint will hurt even in rest. Pain associated with avascular necrosis of the hip might center on the groin, thigh or buttock.

Diagnosis

Diagnosis starts with a physical exam in which the doctor looks for tenderness in the joints and tests the range of motion in the joints. Imaging studies such as X-RAY, MRI, CT and bone scan may be performed. XRAY will usually appear normal at first, and bone changes will be visible only in later stages.

Treatment

Avascular necrosis may be treated with supportive care such as nonsteroidal anti- inflammatory drugs to relieve the pain, osteoporosis drugs may slow down AVN progression, cholesterol-lowering drugs, blood thinners, rest and special exercise to improve range of motion. Usually, AVN is diagnosed only in a late phase that requires surgical treatment. These treatments include Core decompression when a part of the inner layer of the bone is removed, bone transplant to strengthen the area that suffered from the necrosis. Osteotomy, or bone reshaping allows shifting the weight on a different, unaffected, part of the joint. Joint replacement is an option if other treatments have failed or if the bone collapsed.

☝️ This is not a substitute for professional medical advice. Please consult with your physician before making any medical decision.

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Source of Information - We analyze big data of more than 23 million patients de-identified medical records from the following sources:

National Institution of Health ∙ World Health Organization ∙ University of Illinois hospital