Hip pain can sometimes be cause by a condition known as avascular necrosis or Osteonecrosis. It is most common in the hip, but also seen in the humerus (arm), knee and talus (ankle), and more rarely seen in the smaller bones of the wrist such as the lunate or scaphoid.
Avascular necrosis is a degenerative bone condition of the hip and major joints, characterized by the deterioration of bone because of reduced blood supply. Cases from wear and tear will typically present with mechanical hip pain or joint pain of variable onset and severity and often difficult to localize. In early disease, the physical examination is often normal which inevitably causes a delay in diagnosis. Any one can be affected by Avascular necrosis, but people 30 to 50 years of age are at the greatest risk. Avascular necrosis is irreversible, but treatment can slow the progression and help keep the condition from worsening.
What Causes Avascular Necrosis?
It can be caused by traumatic or non-traumatic events
Traumatic
- An injury, such as a dislocated joint, might damage nearby blood vessels one of cause of Avascular necrosis.
- Joint or bone trauma
- A fracture in a bone example: fracture femoral head is common cause.
- Cancer treatments involving radiation also can weaken the bone and harm blood vessels and can cause Avascular necrosis.
Non-traumatic
- Heavy Drinking and steroid abuse have been identified as major risk factors
- Numerous studies have also concluded that hyperlipidemia in the femoral head, induced by steroid and alcohol use, are associated with osteonecrosis. Both factors precipitate an increase in fat volume in the bone marrow and blood lipid levels, thereby increasing the deposition of fat and interrupting blood flow to the femoral head.
- Glucocorticoid intake was found to have an even stronger association than alcohol use.
- Cigarette smoking: due to changes in nitric oxide bioavailability, there is an increased oxidative stress level and endothelial dysfunction
- Obesity: osteonecrosis is positively associated with BMI. Overweight and obesity are, just like steroid and alcohol use, often associated with hyperlipidemia.
- A medical condition, such as sickle cell Anemia or systemic lupus Erythematosus is also one of cause.
Have you been diagnosed with Avascular Necrosis or have any questions? Contact us, we can provide support to relieve pain and reduce the progression.
