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2.1
Avascular Necrosis of Genetic Origin
Osteochondrosis

Presentation

Figure 3 Figure 3: AP Radiograph of the pelvis of F.W. on presentation with right hip pain. Following the presentation of A.B.' [ispub.com]

Symptoms present at birth, and continuous. [102] Symptoms may be present at birth or early infancy. [102] Purpuric rash presenting at birth or in infancy. Vasculitis noted on skin biopsy. [autoinflammatory-search.org]

Avascular necrosis (AVN) is a very rare presenting feature of endogenous hypercortisolaemia. [edmcasereports.com]

Fractures to the talar neck with fragmentation were present. In addition, there appeared to be a fracture to the talar body with slight plantar compression. [podiatrytoday.com]

Palpation for splenic size to ensure early presentation of splenic sequestration can significantly reduce deaths. [patient.info]

Workup

He sent me the following coagulation work up to be performed: COAGULATION WORKUP A COAGULATON WORKUP B The above tests have LabCorp codes. [osteonecrosis.me]

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

No single treatment method will work for all patients, and no single treatment consistently prevents the development of femoral head deformity. [scottishritehospital.org]

To reach these goals, the doctor may use one or more of the following treatments. Non-operative Treatment There is no known pharmaceutical cure for osteonecrosis. [rarediseases.org]

This can sometimes develop following radiotherapy to the head and neck area, bisphosphonates treatment, or after a tooth extraction while having either of the two treatments. [healthand.com]

A new approach to treatment Options to halt the progression of AVN include core decompression, osteotomy and medical treatments. [mayoclinic.org]

Prognosis

[…] contributing authors—twenty of them new to this edition—provide comprehensive coverage of every aspect of cutaneous and systemic lupus erythematosus, including definitions, pathogenesis, autoantibodies, clinical and laboratory features, management, prognosis [books.google.com]

Osteochondroses differ in their anatomic distribution, course, and prognosis; they typically cause pain and have important orthopedic implications. [msdmanuals.com]

: overall prevalence of 9.7% Reports vary: Bishop etal. 19% - 31% Many have bilateral hip involvement Prognosis: Young children have a reasonable potential for healing avascular necrosis, while the older adolescent with total head involvement will likely [gait.aidi.udel.edu]

Etiology

The etiology is controversial. Few reports describe the association with trauma, steroid use and systemic lupus erythematosus. [radiopaedia.org]

Etiology of osteochondroses is typically unknown; some of the disorders have a familial component, but inheritance is complex. [msdmanuals.com]

It is now understood that LCPD is caused by an ischemic injury, yet the exact etiology remains unclear. [ped-rheum.biomedcentral.com]

Thrombophilia and hypofibrinolysis: reversible pathogenetic etiologies of osteronecrosis. In: Urbaniak JR, Jones JP Jr, eds. Osteonecrosis: Etiology, Diagnosis, and Treatment. Rosemont, IL: American Academy of Orthopedic Surgeons, 1997: 105-10. [pancreas.imedpub.com]

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]

Epidemiology ethiology and diagnosis of osteoporosis. Am J Obstet Gynecol. 2006;194:S3–S11. Leon A. Assael. [jpmh.org]

If left untreated, the disease progresses, the bone collapses, [21] and the joint surface breaks down, leading to pain and arthritis. [1] Epidemiology [ edit ] Avascular necrosis usually affects people between 30 and 50 years of age; about 10,000 to 20,000 [en.wikipedia.org]

Support for this concept comes from epidemiological studies in malaria-endemic regions of Africa. [sickle.bwh.harvard.edu]

The epidemiology of slipped capital femoral epiphysis: an update. J Pediatr Orthop. 2006;26(3):286–90. doi:10.1097/01.bpo.0000217718.10728.70. View Article PubMed Google Scholar Steiner C, Elixhauser A, Schnaier J. [ped-rheum.biomedcentral.com]

Pathophysiology

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]

Risk factors for AVN Although the pathophysiology of AVN is not yet well-understood, it is thought to be a multifactorial disease, with patients reporting a history of exposure to one or more risk factors, including trauma to the hip, alcohol abuse, corticosteroid [mayoclinic.org]

Pathophysiology Although the pathophysiology of AVN is not fully understood, the final common pathway is interruption of blood flow to the bone. [emedicine.medscape.com]

American Volume 88 1117 – 1132. ( doi:10.2106/JBJS.E.01041 ) Search Google Scholar Export Citation Glueck CJ Freiberg R Tracy T Stroop D Wang P 1997 Thrombophilia and hypofibrinolysis: pathophysiologies of osteonecrosis. [edmcasereports.com]

Avascular necrosis of the femoral head: etiology, pathophysiology, classification, and current treatment guidelines. Am J Orthop (Belle Mead NJ). 2004;33:327–332. 13. Zhao D, Cui D, Wang B, et al. [dovepress.com]

Prevention

Prevention of this course is paramount to preventing joint replacement surgery. [drlox.com]

The primary goals of treatment for Perthes disease are to alleviate pain and to prevent lasting deformity of the femoral head. [scottishritehospital.org]

Prevention As the saying goes "prevention is the best medicine." If you are taking high doses of steroids for any reason it is important for you to continue to see your doctor on a regular basis. [orthop.washington.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]

Avascular necrosis is presently not preventable but research has shown that lipid lowering drugs such as lipitor can reduce or prevent avascular necrosis in animals. [clinicaltrials.gov]

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