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Avascular (Aseptic) Necrosis of the Femoral Head (Hip), Pediatric

Craig Munns, FRACP, MBBS, PhD Reviewed 10/2018
 


BASICS

DESCRIPTION

  • Avascular (aseptic) necrosis results from the interruption of the blood supply to bone (either traumatic or nontraumatic occlusion).

  • The femoral head is the most common site.

  • A self-li...

DIAGNOSIS

HISTORY

  • Onset (gradual or after traumatic event)

  • Association with the following:

    • Trauma

    • Medications (steroids or chemotherapy)

    • Casting, splinting, surgery (iatrogenic)

    • Pain, limping

    • Stiffness (decr...

TREATMENT

MEDICATION

  • NSAIDs may reduce pain by decreasing associated inflammation but may also reduce new bone formation.

  • If associated with corticosteroid use, discontinuation or elimination of steroid...

ONGOING CARE

DIET

  • Thought not to alter disease process

  • Recommend general balanced diet.

  • During immobilization, excessive weight gain may occur.

PROGNOSIS

  • Depends on extent of femoral head collapse

  • Good if m...

ADDITIONAL READING

  • Lahdes-Vasama T, Lamminen A, Merikanto J, et al. The value of MRI in early Perthes’ disease: an MRI study with a 2-year follow-up. Pediatr Radiol.  1997;27(6):517–522. [View Ab...

CODES

ICD9

  • 733.42 Aseptic necrosis of head and neck of femur

  • 732.1 Juvenile osteochondrosis of hip and pelvis

ICD10

  • M87.059 Idiopathic aseptic necrosis of unspecified femur

  • M91.10 Juvenile osteochondrosis ...

FAQ

  • Q: What type of medication is most often associated with avascular necrosis of the hip?

  • A: Corticosteroids

  • Q: For avascular necrosis in children (Perthes disease of the hip, for example), is younger...

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