Aseptic Necrosis (cont.)
What causes aseptic necrosis?
Aseptic necrosis can be caused by trauma and damage
to the blood vessels that supply bone its oxygen. Other causes
of poor blood circulation to the bone include a blockage by air
or fat (embolism) that obstructs the blood flow through the blood vessels,
abnormally
thick blood (hypercoagulable state), and inflammation of the blood
vessel walls (vasculitis).
What conditions are associated with aseptic
necrosis?
Conditions that are associated with aseptic necrosis
include alcoholism, cortisone medications, Cushing's syndrome, radiation
exposure, sickle cell disease, pancreatitis, Gaucher disease,
and systemic lupus erythematosus. Aseptic necrosis of the jaw bone has been rarely reported in
association with the use of bisphosphonate medication, particularly intravenously including zolendronate
(Zometa) and pamidronate (Aredia ).
What are symptoms of aseptic necrosis?
Aseptic necrosis begins as a painless bone abnormality. It can remain painless. The involved bone often later develops pain, especially with use. For example, if a hip joint develops avascular necrosis in the ball of the hip joint, pain can be noted - especially with weight-bearing. As the ball of the hip joint collapses from the degeneration of the bone from aseptic necrosis, pain in the groin can be felt with hip rotation and pain can sometimes be noted with rest after weight-bearing.
How is aseptic necrosis
diagnosed?
The diagnosis of aseptic necrosis can often, but not always, be made with
x-rays. By the time changes are apparent by plain film x-ray testing there has been substantial damage to the bone affected. Bone changes visible on plain film x-ray are therefore considered a later-stage finding. Earlier signs of avascular
necrosis can be detected with an MRI scan or suggested by a nuclear
bone scan.
Next: What is the treatment for aseptic necrosis? »
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