Hip, Leg & Spine Problems

Question 1

Define avascular necrosis

Answer 1

Death of bone tissue 2ary to loss of blood supply

This leads to bone destruction and loss of joint function.

Question 2

Where does avascular necrosis commonly affect?

Answer 2

The epiphysis of long bones such as the femur.

Question 3

Give some causes of avascular necrosis of the hip

Answer 3

1) long term steroid use

2) chemotherapy

3) alcohol excess

4) trauma

Question 4

Features of avascular necrosis?

Answer 4

Initially asymptomatic, then pain in the affected joint

Question 5

What is the investigation of choice in avascular necrosis?

Answer 5

MRI

Question 6

What is lumbar spinal stenosis?

Answer 6

A condition in which the central canal is narrowed by tumour, disk prolapse or other similar degenerative changes.

Question 7

Features of lumbar spinal stenosis?

Answer 7

• back pain
• neuropathic pain
• symptoms mimicking claudication

Question 8

What is one of the main features that may help to differentiate spinal stenosis from true claudication?

Answer 8

Positional element to the pain:

Sitting is better than standing and patients may find it easier to walk uphill rather than downhill.