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Avascular Necrosis

Avascular Necrosis

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Published by bjpalmer

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Published by: bjpalmer on Jul 19, 2009
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02/05/2013

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MRIMRI
 Avascular Necrosis of the Hip Avascular Necrosis of the Hip
Edward C. Fritsch, D.C.Edward C. Fritsch, D.C.
 
 
OverviewOverview
Avascular necrosis (AVN) is cellular death of the componentsAvascular necrosis (AVN) is cellular death of the componentsof bone, including bone marrow, due to impaired blood supply.of bone, including bone marrow, due to impaired blood supply.AVN occurs in a number of conditions.AVN occurs in a number of conditions.AVN usually involves the epiphysis of long bones.AVN usually involves the epiphysis of long bones.
 – Called bone infarct if in diaphysis or metaphysisCalled bone infarct if in diaphysis or metaphysis
AVN of the hip is the most common encountered in clinicalAVN of the hip is the most common encountered in clinical practice. practice.Early diagnosis and appropriate intervention can delay the needEarly diagnosis and appropriate intervention can delay the needfor joint replacement.for joint replacement.Patients on corticosteroids and organ transplant recipients arePatients on corticosteroids and organ transplant recipients are particularly at risk of developing AVN. particularly at risk of developing AVN.
 
 
Pathophysiology:Pathophysiology:
 
AVN is due to blood supply disruption, and itAVN is due to blood supply disruption, and itaffects bones with single terminal blood supply.affects bones with single terminal blood supply.
 – Mechanical interruption of blood supply.Mechanical interruption of blood supply. – Thrombotic or embolic occlusion of blood vessel.Thrombotic or embolic occlusion of blood vessel. – Injury to vessel wallInjury to vessel wall – Pressure on vessel wallPressure on vessel wall – Mechanism unknown (eg, high dose corticosteroids,Mechanism unknown (eg, high dose corticosteroids,alcoholism, primary AVN)alcoholism, primary AVN)

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