AVN
Avascular Necrosis (AVN), also known as osteonecrosis, is a condition characterized by the death of bone tissue due to a lack of blood supply. This can lead to tiny breaks in the bone and the bone's eventual collapse. Avascular necrosis most commonly affects the ends of long bones such as the femur, the bone extending from the knee joint to the hip joint. However, it can affect any bone, including those in the upper arm, knees, shoulders, ankles, and hands.
The exact cause of AVN is not fully understood, but several factors are known to increase the risk of developing this condition. These include trauma to a bone or joint, long-term use of high-dose steroid medications, excessive alcohol consumption, and specific medical conditions such as blood clots, sickle cell anemia, and pancreatitis. The condition can also arise from the decompression sickness experienced by divers.
Symptoms of AVN include joint pain, which may only be noticeable when putting weight on the affected joint, and limited range of motion in the affected joint. Initially, individuals may not experience any symptoms, but as the condition progresses, pain can become more constant, even occurring at rest.
Diagnosis of AVN typically involves a combination of patient history, physical examination, and imaging tests. Magnetic resonance imaging (MRI) is the most sensitive method for early detection of the condition, while X-rays may be used to see bone changes that occur in later stages of AVN.
Treatment for AVN aims to prevent further bone loss and relieve pain. Options include medications to reduce pain and swelling, physical therapy, and in some cases, surgical procedures such as core decompression, bone grafts, or joint replacement. The choice of treatment depends on the stage of the disease, the bone affected, and the underlying cause.
Early diagnosis and treatment of AVN are crucial for improving the outcome and preventing joint collapse. If left untreated, avascular necrosis can lead to severe arthritis in the affected joint and significant limitations in movement.
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Contributors: Prab R. Tumpati, MD