Presentation
A 26 year old lady presented with right sided hip pain and diagnosed as avascular necrosis of the femoral head. After 6 months she presented a similar pain in left hip, which revealed avascular necrosis of left femoral head as well. [ncbi.nlm.nih.gov]
Entire Body System
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Pain
At the initial visit to our department, the patient was noted to have a painful trigger wrist that was brought on by wrist flexion and extension. [ncbi.nlm.nih.gov]
Jaw & Teeth
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Oral Ulcers
Rashes and oral ulcers were not associated with AVN. Mean daily dose of CS and duration of CS use had no impact on AVN occurence. [ncbi.nlm.nih.gov]
Ears
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Progressive Hearing Loss
Patients complain on progressive hearing loss and tinnitus. The diagnosis is made clinically by conventional audiologic evaluation and radiologically by x-ray mastoid Schuller's view and CT scan. [ncbi.nlm.nih.gov]
Musculoskeletal
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Wrist Pain
A 24-year-old woman presented with right wrist pain of 12 months duration. She reported no major trauma and reported that her pain had begun during the third month of her pregnancy. [ncbi.nlm.nih.gov]
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Metatarsalgia
If the surgeon encounters significant bone loss, he or she should add a block of autogenous bone graft to maintain length of the first ray and prevent transfer metatarsalgia. [podiatrytoday.com]
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Ankle Pain
A diagnosis of avascular necrosis should be considered in patients with atraumatic foot and ankle pain, especially in the presence of risk factors such as alcohol excess and smoking. [ncbi.nlm.nih.gov]
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Short Arm
The patient was placed in a short-arm thumb spica cast, with a window for a bone stimulator, for 14 weeks. At the conclusion of the treatment, the pain had resolved and x-ray and computed tomography scan demonstrated bony union. [ncbi.nlm.nih.gov]
Neurologic
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Dysphasia
AIMS: The aim of this study was to evaluate the correlation between Salter's criteria and Kalamchi's classification of avascular necrosis in patients treated for developmental dysphasia of the hip (DDH). [ncbi.nlm.nih.gov]
Workup
This staging system was revised after the widespread use of MRI in the workup of AVN. [orthopaedicsone.com]
The purpose of this article is to report a prototypical case with complete radiographic and histologic workup and to provide facts regarding Kummel disease that are salient to the primary care provider. [doi.org]
See Workup. Early diagnosis and appropriate intervention can delay the need for joint replacement. However, most patients present late in the disease course. [emedicine.medscape.com]
Treatment
These patients were treated by conservative treatment (non surgical) in three cases, vascularized bone graft in two and palliative treatments (proximal row carpectomy or partial fusion) in five. [ncbi.nlm.nih.gov]
Early diagnosis and treatment of this entity are crucial because it affects relatively young individuals, and treatment options for advanced disease are limited. [doi.org]
Prognosis
RESULTS: S1 and S2 criteria were predictive of a poor prognosis. The outcome following S3, S4 and S3 S4 varied; 18 (40%) had a good prognosis, 17 (38%) a fair prognosis and ten (22%) a poor prognosis. [ncbi.nlm.nih.gov]
In addition, lesion size and location can be more easily assessed on magnetic resonance images, and this has been shown to relate to prognosis and need for treatment. [doi.org]
We know that the older the child is, the worse the prognosis. Most agree that children younger than 6 years do not require surgical treatment or even treatment with a brace. [lifebridgehealth.org]
Etiology
The most common reported etiology is trauma. We report a case of avascular necrosis of the capitate in a patient with chronic wrist pain that began after a single episode of remote trauma. [ncbi.nlm.nih.gov]
Although bone scintigraphy using single photon emission computed tomography (CT) may be nearly as accurate as MRI, MRI offers a more specific diagnosis in the patient who presents with hip pain of uncertain etiology. [doi.org]
Epidemiology
Epidemiology Frequency United States The frequency of AVN depends on the site involved. The most common site is the hip; other locations include the carpals, talus, femur, metatarsal, mandible, and humerus. [emedicine.medscape.com]
Pathophysiology
We will review the pathophysiologic mechanisms of AVN and the current use of MRI in the diagnosis of this condition. [ncbi.nlm.nih.gov]
The pathophysiology of avascular necrosis of the femoral head has not been completely accounted for. In some patients there has clearly been a direct cause (trauma, radiation,..), while in others the pathophysiology is still uncertain. [physio-pedia.com]
Prevention
OBJECTIVES: To assess the effects of pharmacological interventions for preventing insufficiency fractures and avascular necrosis in adults over 18 years of age undergoing pelvic radiotherapy. [ncbi.nlm.nih.gov]
In cases of AVN of the hip, it is very important to diagnose and treat early in order to prevent disability. [hss.edu]