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...
Onset (gradual or after traumatic event)
Association with the following:
Trauma
Medications (steroids or chemotherapy)
Casting, splinting, surgery (iatrogenic)
Pain, limping
Stiffness (decr...
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...
Thought not to alter disease process
Recommend general balanced diet.
During immobilization, excessive weight gain may occur.
Depends on extent of femoral head collapse
Good if m...
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...
733.42 Aseptic necrosis of head and neck of femur
732.1 Juvenile osteochondrosis of hip and pelvis
M87.059 Idiopathic aseptic necrosis of unspecified femur
M91.10 Juvenile osteochondrosis ...
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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<bold>FIG. 6.44.</bold> Magnetic resonance imaging appearance of avascular necrosis. A: Transverse T<sub>1</sub>-weighted image of a patient (supine) with hip pain on long-term steroid therapy for lupus erythematosus shows nonspecific marrow edema (<italic>arrow</bold>) in the left femoral head (<italic>f</bold>). The location and clinical context of this finding are suggestive of avascular necrosis, but the imaging appearance is otherwise nonspecific. <italic>a</bold>, acetabulum; <italic>b</bold>, bladder. Sagittal T<sub>1</s...
<bold>FIG. 6.44.</bold> Magnetic resonance imaging appearance of avascular necrosis. A: Transverse T<sub>1</sub>-w...
<bold>FIG. 49.14.</bold> Anteroposterior radiograph of the pelvis after hip arthrodesis with subtrochanteric osteotomy in a 300-pound 18-year-old man with end-stage avascular necrosis of the hip. Subtrochanteric osteotomy was performed to reduce the moment arm and improve the union rate of the arthrodesis in this large individual. The subtrochanteric osteotomy healed uneventfully with a spica cast, and allowed optimal positioning of the extremity.
<bold>FIG. 49.14.</bold> Anteroposterior radiograph of the pelvis after hip arthrodesis with subtrochanteric osteotomy in a 30...
<bold>FIG. 95.7.</bold> Radiograph of the left hip joint of a 22-year-old man with Gauchers disease illustrating avascular necrosis of the head of the femur. This radiograph was obtained 2 years after the onset of pain in the hip.
<bold>FIG. 95.7.</bold> Radiograph of the left hip joint of a 22-year-old man with Gauchers disease illustrating avascular ne...
FIG. 12.6. Osteochondritis dissecans. A: The anteroposterior view in normal. B: The tunnel view clearly shows a defect of the subchondral bone.
FIG. 12.6. Osteochondritis dissecans. A: The anteroposterior view in normal. B: The tunnel view clearly shows a defect of the subchondral ...
<bold>Fig B 14-3. Osteochondritis dissecans</bold> (arrow) at the ankle.
<bold>Fig B 24-7. Osteochondritis dissecans.</bold> (A) Knee. (B) Ankle.
<bold>FIG. 6.44.</bold> Magnetic resonance imaging appearance of avascular necrosis. A: Transverse T<sub>1</sub>-we...
FIGURE 16-3. Anteroposterior radiograph of a 62-year-old patient's distal femur. The patient had pain for 4 weeks before sustaining a nondisplaced fracture through a lesion in her distal lateral femur. Its appearance on the plain radiograph is suggestive of a metastatic lesion. No other lesions were found and a biopsy was done. The lesion proved to be a primary malignant fibrohistiocytoma of bone. She had a limb salvage resection after preoperative chemotherapy.
FIGURE 16-3. Anteroposterior radiograph of a 62-year-old patient's distal femur. The patient had pain for 4 weeks before sustaining a nond...