Necrosis

of the bone due interruption of its blood supply Common sites : humeral head, femoral head , scaphoid , talus , lunate causes : traumatic & non-traumatic

 Sickle

cell disease Drugs : high steroids , alcohol abuse , chemotherapy , immunosuppresive drugs Radiation Infections : septic arthritis , OM SLE Perthes disease

 Interruption

of blood supply Compression of sinusoids by marrow swelling raised intraosseous pressure Intravascular thrombosis

 Asymptomatic

unless when OA has developed Painful hip , Stiffness , and restricted ROM

 Xray

not sensitive during early stages.2-3 months after onset : increased density ( sclerosis ) collapse destruction & deformity of articular cartilage MRI Other blood tests : CBC , LFT , Clotting profile

 Hx

: ask about traumatic & non-traumatic causes Family hx of sickle cell disease Chronic / high dose steroids intake Alcohol abuse history ( CAGE Qs or lab results high MCV , Hi GGT , Hi transaminases

 Athrodesis

in young Athroplasty in elderly