Avascular Necrosis Flashcards
what is avascular necrosis?
an interruption to subchondral blood supply causing the death of cellular bone components
what is AVN also called?
osteonecrosis
what are the 3 most common sites of AVN?
femoral head
knee
humeral head
what is the most common location of AVN occurance?
hip
what are 3 causes of AVN?
fracture leading to damaged blood vessel
damage to inside of blood vessel (radiation)
clot to blood vessel
what are 4 major risk factors for developing AVN?
cellular toxicity
trauma
vascular abnormalities
bisphosphonate use > 5 yrs
what is the primary symptom of AVN?
pain
what is the 1st line imaging for AVN?
xray
what imaging is best for early diagnosis of AVN?
MRI
at what stage of AVN are xrays normal but MRI reveals death of bone?
stage I
at what stage of AVN do xrays show evidence of AVN without collapse of the femoral head?
stage II
at what stage of AVN do xrays show signs of collapse “crescent sign”?
stage III
at what stage of AVN do xrays show collapse and signs of cartilage damage (arthritis)?
stage IV
identify stage
stage II
identify stage
stage III
identify stage
stage IV
identify stage
stage II
identify stage
stage III
identify stage
stage II
what is the goal of treatment of AVN?
prevent further bone loss
what is the treatment for AVN? (4)
NSAIDs
cholesterol-lowering drugs
blood thinners
+/- PT
what is the possible surgical option for AVN if it is in an advanced stage without others options?
total hip arthroplasty
what is a complication of AVN?
severe arthritis
what is AVN of the femoral head in children called?
Legg-Calve-Perthes Disease
what can occur if AVN in children is left untreated? (2)
permanent deformity
osteoarthritis as an adult
a child presents with a painless limp, decreased hip ROM, and worsened pain during activity. Dx?
Legg-Calve-Perthes Disease
in which children is Legg-Calve-Perthes Disease common in?
those exposed to second-hand smoke
what is the nonsurgical treatment for Legg-Calve-Perthes Disease? (4)
bed rest
NSAIDs
casting/bracing
physical therapy
what is the surgical option for Legg-Calve-Perthes Disease?
femoral osteotomy
