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Osteonecrosis (Avascular necrosis)

Osteonecrosis is a disease in which bone tissue is damaged due to reduced blood flow. Symptoms and treatment options vary depending on the cause and the stage of progression.

osteonecrosis · bone necrosis · ischaemic bone disease · ischemic bone disease · osteonecrosis

MONDO:0005380Public QA completeSource-bound · 4

Disease at a glance

Start with the essentials, then explore the patient and research views.

Public revision · 01b3217a81fe

Disease category
Osteonecrosis (avascular necrosis) is a disease in which bone is damaged and collapses faster than new bone is formed due to reduced blood flow to the bones around the joints.
Core mechanism
The cause is not always clear, but long-term steroid use, excessive alcohol consumption, joint injury, and diseases such as arthritis or cancer can be related factors.
Main causes · related factors
Reduced blood flow hinders bone cell survival and bone remodeling, and over time, the bone structure weakens, potentially leading to deformation or collapse of the articular surface.
Representative patterns
The upper part of the femur is the most common site, but it can also occur in the shoulder, knee, and ankle, with joint pain and limited movement being representative symptoms.
Individual differences
It can occur in men and women of various ages, but is commonly mentioned in those in their 30s to 50s; individual progression varies depending on risk factors, the site of involvement, and the extent of damage.
Diagnosis
There may be no symptoms in the early stages, but as it progresses, pain can intensify, making it difficult to bend or move the joint.
Management
Diagnosis is made by confirming symptoms, medical history, and risk factors, and then synthesizing the results of imaging tests and necessary additional tests.
Treatment/Research Status
Since early lesions may not be distinct on plain X-rays, one should not conclude based on imaging alone, but rather interpret the stage and size of the lesion along with the possibility of contralateral involvement.
Read Evidence
Management is carried out by considering the location and progression of the lesion, pain and function, and causative factors to review conservative methods such as weight-bearing adjustment and crutches, as well as procedures or surgery.
Key Precautions
Treatments mentioned include medication, activity restriction, crutches, electrical stimulation, and surgery, but the selection and effectiveness of a specific method vary depending on the stage and individual circumstances.

For patients and families

A structured guide for understanding the disease and preparing for clinical conversations.

At a Glance

Osteonecrosis (avascular necrosis) is a disease in which bone is damaged and collapses faster than new bone is formed due to reduced blood flow to the bones around the joints.

The upper part of the femur is the most common site, but it can also occur in the shoulder, knee, and ankle, with joint pain and limited movement being representative symptoms.

How the disease works

The cause is not always clear, but long-term steroid use, excessive alcohol consumption, joint injury, and diseases such as arthritis or cancer can be related factors.

Reduced blood flow hinders bone cell survival and bone remodeling, and over time, the bone structure weakens, potentially leading to deformation or collapse of the articular surface.

Variations in presentation among individuals

It can occur in men and women of various ages, but is commonly mentioned in those in their 30s to 50s; individual progression varies depending on risk factors, the site of involvement, and the extent of damage.

The broad framework of diagnosis and management

There may be no symptoms in the early stages, but as it progresses, pain can intensify, making it difficult to bend or move the joint.

Diagnosis is made by confirming symptoms, medical history, and risk factors, and then synthesizing the results of imaging tests and necessary additional tests.

Current status of treatment

Since early lesions may not be distinct on plain X-rays, one should not conclude based on imaging alone, but rather interpret the stage and size of the lesion along with the possibility of contralateral involvement.

Management is carried out by considering the location and progression of the lesion, pain and function, and causative factors to review conservative methods such as weight-bearing adjustment and crutches, as well as procedures or surgery.

Treatments mentioned include medication, activity restriction, crutches, electrical stimulation, and surgery, but the selection and effectiveness of a specific method vary depending on the stage and individual circumstances.

How to read clinical trials

In follow-up, changes in pain, function, and imaging must be confirmed, and the mere existence of registered observational studies or research papers cannot be used to judge treatment efficacy, safety, or approval.

Points to verify during clinical consultations

In clinical practice, it is possible to assess the onset and changes in pain, bilateral symptoms, use of steroids, alcohol consumption, trauma, underlying diseases, current medications, gait and daily function, necessary imaging tests, and follow-up plans.

Medical Guidance

This material is for educational purposes and is not intended as a guide for individual diagnosis or treatment. Please consult medical staff if you have symptoms or risk factors.

Evidence and sources

A trial registry status does not establish efficacy or regulatory approval.