Avascular Necrosis: Guideline, Symptoms, & Treatment

You might have just been from the hospital because a joint on your body felt strange these past few days. The doctor explained the cause of pain in the joints of the bones in the body is due to Avascular Necrosis.

It is very strange to our ears, even though the doctor has explained, certainly it would always good idea to look for literacy from the internet a guideline to overcome Avascular Necrosis.

This post was written based on valid sources and briefly summarized so you can easily understand it. Even so the information and advice from this post do not aim to replace a doctor’s prescription. We strongly recommend that you go to orthopedics if you experience aviscular symptoms

What is Avascular Necrosis ?

Avascular necrosis in knee
Your life changed when you feel something strange in your joint, isn’t it?

Avascular necrosis also know as osteonecrosis is a condition when bone tissue that damaged / dies due to lack of blood supply. In the initial stages, avascular necrosis is generally no symptom (asymptomatic). But over time, the affected joint will feel pain when it’s moving.

Then the joints will feel painful, even if the patient is just lying down. Pain it can be mild or severe, pain will feel more severe in joints that hold body weight, such as joints in the groin or buttocks. In addition, pain can also be felt in the shoulders, knees, hands and feet.

The pain can be increased because of the presence of microfractures or small cracks in the bone. This condition can cause bone death and joint damage that develops into arthritis, and soon will limit movement.

Please note, the time interval from the first symptom appears until the patient is difficult to move, varies in each patient, can be in a matter of months or more than one year. Symptoms can also appear on both sides of the body, such as the thighs or knees.

Avascular Necrosis Cause

Avascular necrosis occurs because of a disturbance or reduced blood supply to the bones. Lack of blood in join mean our join lacks of mineral, if machine it was like lack of oil. Soon certainly it will damage our join.

Here’s some common conditions that can make the supply of blood to the bone reduced:

  • Injury to joints or bones. Injuries such as joint dislocations can damage surrounding blood vessels.
  • Fat accumulation in blood vessels. Fat can close small blood vessels and result in reduced blood supply to the bones. This can happen to people who use corticosteroids in long-term or people that addicted to alcohol.
  • Disease like: Sickle cell anemia or Gaucher’s disease, can reduce blood supply to the bones. In addition, other diseases that can cause avascular necrosis are pancreatitis, diabetes, lupus, and HIV / AIDS.
  • Medical treatment. Medical procedures, such as radiotherapy, can weaken bones and damage blood vessels. Also kidney transplantation is associated with avascular necrosis.

However, the cause of osteonecrosis is not always within these disease. It can occur in healthy individuals without having the above risk factors.

Symtomps of Avascular Necrosis

Our narration above is clearly explain symptoms of Avascular Necrosis. But to make it clear here’s common symptoms of osteonecrosis list.

  • Pain when putting a strain on the affected bone.
  • The pain will increase when the bones and surrounding areas move.
  • The limitation moves the joint so it might stuck cannot use it at all.

When you experienced that symptoms your osteonecrosis might not in initial stage. Usually you will feel pain when it’s get worse.

Avascular necrosis is more prone to attack men than women. However, women with lupus are also at risk of developing this disease. Although osteonecrosis can occur at any age, commonly attack people aged 30-60 years.

Diagnosis of Avascular Necrosis

The orthopedic will asking patient for a history of symptoms and physical examination result, then after that the orthopedic will run examinations.

X-rays will be taken to see the bone changes that occur in avascular necrosis. If the X-ray imaging results show no problems and the patient also has no risk factors for this disease, then the doctor will recommend a bone scan.

This examination begins with injecting radioactive substances into a vein. The substance will go to the bone area that is disturbed and will be caught when doing photos with a gamma camera.

Can MRI or CT Scan Detect Avascular Necrosis?

Certainly, Yes. Both MRI and CT scan can detect abnormal thing in your bone that might X Ray can’t see due it limitation.

So, which is better CT scan or MRI to detect Avascular Necrosis?

It depends on your condition. Orthopedic know the best technology to detect abnormal in your joint. But let me give you a hint which is better since both have advantages and disadvantages.

You might interested Can CT Scan detect colon cancer?

If you Pregnant then your doctor will recommended using MRI Scan. Since it safest for baby and mother. But if you had or have something metal in your body like stent (heart ring) or piercing then CT scan is right for you. CT scan not using magnet and less time consuming than MRI.

Worst case if the doctor still suspects that the patient has osteonecrosis even though all imaging tests do not indicate the presence of this disease,. The patient may be advise to undergo a surgical test to measure pressure on the diseased bone. This test is well known as functional bone test.

Treatment and Prevention of Avascular Necrosis

Treatment for patients with avascular necrosis depends on age, cause of disease, damaged bone parts, and the level of damage. Here’s list therapies and treatments that doctors recommend is to treat osteonecrosis in its early stages :

  • Nonsteroidal anti-inflammatory drugs (NSAIDS). Medications such as ibuprofen or diclofenac can reduce signs of inflammation, such as pain due to avascular necrosis.
  • Cholesterol-lowering drugs. Decreased levels of fat in the blood can help prevent clogging of blood vessels that can trigger avascular necrosis. (used by doctor’s prescription)
  • Anticoagulants. Anticoagulant drugs, such as warfarin, will be recommend to prevent blood clots. (used by doctor’s prescription)
  • Bisphosphonate drugs. In some cases, bisphosphonates such as alendronate can slow the progression of avascular necrosis. However, there are reports that bisphosphonates actually make avascular necrosis of the jawbone. (used by doctor’s prescription)

If you experience the condition of avascular necrosis, you should not do activities that can burden the diseased bone. Usually orthopedics will recommended physiotherapy to help maintain and improve joint function.

Surgical Procedures Avascular Necrosis

At worst case when the illness is severe, the doctor will recommend surgical procedures, such as:

  • Bone transplantation. This procedure aims to strengthen the damaged bone, by removing healthy bones from other areas of the patient’s body.
  • Joint replacement. If the diseased part is no longer possible to repair, patients can undergo surgery to replace damaged joints with metal imitation joints.
  • The damaged part of the bone will be removed The bone part that is still healthy is expect to reshape structure to strengthen the pedestal in the joint, so that it can be used better.
  • Decompression of core bone. The procedure carried out is to remove the inside of the bone to reduce the burden on the joints, and to form new blood vessels.
  • This disease can be prevented by avoiding alcohol consumption and keeping cholesterol at normal values. If the patient is a corticosteroid user, be sure to consult with a doctor to monitor their use. Bone damage can get worse if accompanied by the use of corticosteroids.

Meanwhile, to prevent avascular necrosis in the jaw, it is recommendeto regularly clean the teeth and visit the dentist for dental examination and treatment, especially for those undergoing treatment with bisphosphonates.

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