Avascular necrosis; Osteonecrosis; Ischemic bone necrosis; AVN; Aseptic necrosis
Osteonecrosis is bone death caused by poor blood supply to the area. It is most common in the hip and shoulder, but can affect other large joints such as knee, elbow, wrist and ankle.
Osteonecrosis occurs when part of the bone does not get blood and dies. After a while the bone can collapse. If this condition is not treated, the joint will deteriorate and this will become severe arthritis.
Osteonecrosis can be caused by disease, or a severe trauma, such as a break or dislocation, that affects the blood supply to the bone. Many times, no trauma or disease is present. This is called "idiopathic osteonecrosis" -- meaning it occurs without any known cause.
The following can cause osteonecrosis:
Some diseases that may be associated with the development of this condition include:
When osteonecrosis occurs in the shoulder joint, it is usually due to long-term treatment with steroids or a history of trauma to the shoulder.
Legg-Calvé-Perthes disease is a similar condition seen in children and adolescents.
Chang C, Greenspan A, Gershwin ME. Osteonecrosis. In: Firestein GS, Budd RC, Harris ED Jr, et al, eds. Kelley's Textbook of Rheumatology. 8th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 94.
Shah A, Busconi B. Hip, pelvis, and thigh: Hip and pelvis. In: DeLee JC, Drez D Jr, Miller MD, eds. DeLee and Drez’s Orthopaedic Sports Medicine. 3rd ed. Philadelphia, Pa: Saunders Elsevier; 2009:chap 21, section A.
Williams MD, Edwards TB, Shoulder: Glenohumeral Arthritis in the Athlete. In: DeLee JC, Drez D Jr, Miller MD, eds. DeLee and Drez’s Orthopaedic Sports Medicine. 3rd ed. Philadelphia, Pa: Saunders Elsevier; 2009:chap 17, section L.
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