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
- 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]
Pain The included trial did not show differences in the pain measures between the groups compared. [doi.org]
- Increased Susceptibility to Infections
Clinical Considerations Chronic Hemolytic Anemia Chronic Organ Damage Anemic Crisis Vaso-Occlusive Crisis Systemic Manifestations: Increased susceptibility to infection Impaired Growth Musculoskeletal Manifestations Infarction Marrow Hyperplasia Spontaneous [gait.aidi.udel.edu]
- Soft Tissue Swelling
Clinical presentation • Child up to 1 year. • High grade fever & hyperirritability. • Painful deep soft tissue swelling occurs before bone lesion appear. • Soft tissue swelling is very painful and is deeply situated and not accompanies by surface redness [slideshare.net]
Gastrointestinal
- Suprapubic Pain
In January 1988, she experienced suprapubic pain which radiated to the left lower quadrant. MRI and scintigram demonstrated bilateral femoral head osteonecrosis ( arrow on MRI ). [med.harvard.edu]
Ears
- 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
- 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]
Neurologic
- 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]
MI), admission is indicated to a unit with telemetry monitoring and transcutaneous pacing capabilities Symptomatic patients should be treated with atropine and transcutaneous pacing immediately, followed by transvenous temporary pacing until further workup [emedicine.medscape.com]
Besides confirming the diagnosis, another major role for the radiologist in the workup of osteonecrosis is staging the current state of the disease. The usual plain film and MR stages are listed below. [rad.washington.edu]
This should be managed like a type II with transcutaneous or transvenous pacing until further workup can be completed. [ncbi.nlm.nih.gov]
X-Ray
- Periostal Elevation
elevation Residual ossification Dense amorphous chalky zones ( Infarcts ) Avascular Necrosis: Intravascular sickling of RBC in the micro - circulation of the bone results in intramedullary sludging, stasis, thrombosis, destruction of the vessel walls [gait.aidi.udel.edu]
- Schmorl's Nodes
• Schmorl’s nodes are seen with narrow disc spaces. • Vertebral defects are bound by sclerotic rims, which are not seen in TB. • Residual wedging in late cases mat be indistinguishable from compression fracture. 39. [slideshare.net]
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. [doi.org]
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
In cases of AVN of the hip, it is very important to diagnose and treat early in order to prevent disability. [hss.edu]
The best way to prevent AVN is to maintain strength and flexibility. Be sure to warm up before any physical activity and include strength training in your workouts. [upmc.com]