Avascular necrosis of hip - Revision history

Rossdonaldson1 at 19:11, 13 May 2021

2021-05-13T19:11:35Z

← Older revision		Revision as of 19:11, 13 May 2021
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	==Background==		==Background==
			[[File:Osteonecrosis of Hip.jpg\|thumb\|Kupe MD. Hip Fracture. http://drkupe.blogspot.com/2011/03/hip-fracture.html. Accessed July 31, 2016.]]
	Traumatic and nontraumatic causes can lead to an insult to the blood supply of the joint. The ischemia causes death of osteocytes and bone marrow that leads to necrosis and eventual collapse of the dead segment.		Traumatic and nontraumatic causes can lead to an insult to the blood supply of the joint. The ischemia causes death of osteocytes and bone marrow that leads to necrosis and eventual collapse of the dead segment.

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	==Evaluation==		==Evaluation==
	~~[[File:Osteonecrosis of Hip.jpg\|thumb\|Kupe MD. Hip Fracture. http://drkupe.blogspot.com/2011/03/hip-fracture.html. Accessed July 31, 2016.]]~~
	[[File:Osteonecrosis femur 1.jpg\|thumb\|Plain XR Osteonecrosis Femur by JMarchn(own work)]]		[[File:Osteonecrosis femur 1.jpg\|thumb\|Plain XR Osteonecrosis Femur by JMarchn(own work)]]
	[[File:Osteonecrosis MRI femur 2img.jpg\|thumb\|MRI Osteonecrosis Femur by JMarchn (ownwork)]]		[[File:Osteonecrosis MRI femur 2img.jpg\|thumb\|MRI Osteonecrosis Femur by JMarchn (ownwork)]]

Rossdonaldson1 at 19:01, 13 May 2021

2021-05-13T19:01:07Z

← Older revision		Revision as of 19:01, 13 May 2021
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	==Background==		==Background==
	Traumatic and nontraumatic causes can lead to an insult to the blood supply of the joint. The ischemia causes death of osteocytes and bone marrow that leads to necrosis and eventual collapse of the dead segment.		Traumatic and nontraumatic causes can lead to an insult to the blood supply of the joint. The ischemia causes death of osteocytes and bone marrow that leads to necrosis and eventual collapse of the dead segment.

	~~[[File:Osteonecrosis of Hip.jpg\|thumb\|Kupe MD. Hip Fracture. http://drkupe.blogspot.com/2011/03/hip-fracture.html. Accessed July 31, 2016.]]~~
	~~[[File:Osteonecrosis femur 1.jpg\|thumb\|Plain XR Osteonecrosis Femur by JMarchn(own work)]]~~
	~~[[File:Osteonecrosis MRI femur 2img.jpg\|thumb\|MRI Osteonecrosis Femur by JMarchn (ownwork)]]~~

	===Epidemiology===		===Epidemiology===
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	==Evaluation==		==Evaluation==
			[[File:Osteonecrosis of Hip.jpg\|thumb\|Kupe MD. Hip Fracture. http://drkupe.blogspot.com/2011/03/hip-fracture.html. Accessed July 31, 2016.]]
			[[File:Osteonecrosis femur 1.jpg\|thumb\|Plain XR Osteonecrosis Femur by JMarchn(own work)]]
			[[File:Osteonecrosis MRI femur 2img.jpg\|thumb\|MRI Osteonecrosis Femur by JMarchn (ownwork)]]
	*Plain XR is poorly sensitive in early stages, as low as 41%		*Plain XR is poorly sensitive in early stages, as low as 41%
	**AP and Frog leg views		**AP and Frog leg views

Rossdonaldson1 at 18:59, 13 May 2021

2021-05-13T18:59:10Z

← Older revision		Revision as of 18:59, 13 May 2021
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	*Stoica Z et al. Imaging of Avascular Necrosis of Femoral Head: Familiar Methods and Newer Trends. Curr Health Sci J. 2009 Jan-Mar; 35(1): 23–28.		*Stoica Z et al. Imaging of Avascular Necrosis of Femoral Head: Familiar Methods and Newer Trends. Curr Health Sci J. 2009 Jan-Mar; 35(1): 23–28.
	*Wainwright A. Legg-Calve-Perthes disease diagnostic tests - Epocrates online. Epocrates. https://online.epocrates.com/diseases/75134/Legg-Calve-Perthes-disease/Diagnostic-Tests. Accessed July 31, 2016.		*Wainwright A. Legg-Calve-Perthes disease diagnostic tests - Epocrates online. Epocrates. https://online.epocrates.com/diseases/75134/Legg-Calve-Perthes-disease/Diagnostic-Tests. Accessed July 31, 2016.


	[[Category:Orthopedics]]		[[Category:Orthopedics]]

Josgood: /* Management */

2017-04-09T13:18:07Z

Management

← Older revision		Revision as of 13:18, 9 April 2017
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	**Total Join Replacement		**Total Join Replacement
	**Unfortunately, patients with osteonecrosis have an increased failure rate of the procedure.		**Unfortunately, patients with osteonecrosis have an increased failure rate of the procedure.
	*~~On going~~ research for treatment		*Ongoing research for treatment
	**Joint preserving operations, Bone marrow decompression therapy, vascularized and nonvascularized bone grafts, Bone marrow grafting, and Osteotomy		**Joint preserving operations, Bone marrow decompression therapy, vascularized and nonvascularized bone grafts, Bone marrow grafting, and Osteotomy

Josgood: /* Management */

2017-04-09T13:17:48Z

Management

← Older revision		Revision as of 13:17, 9 April 2017
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	**Bedrest, limit weightbearing, pain control		**Bedrest, limit weightbearing, pain control
	*Medications		*Medications
	**Bisphophonates, vasodilators, and anticoagulants have been used but efficacy has not yet been proven		**Bisphophonates, vasodilators, and [[Anticoagulants\|anticoagulants]] have been used but efficacy has not yet been proven
	*Surgical		*Surgical
	**Total Join Replacement		**Total Join Replacement

Jesselee7: Organization

2016-08-02T15:53:30Z

Organization

← Older revision		Revision as of 15:53, 2 August 2016
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	==Disposition==		==Disposition==
	~~Medical~~ and orthopedic referrals for evaluation of comorbidities and evaluation of joint ~~should be made~~ in the emergency department.		It is vital to order medical and orthopedic referrals for evaluation of comorbidities and evaluation of joint in the emergency department.
	*Progression to subchondral collapse if untreated		*Progression to subchondral collapse if the diagnosis is missed and untreated
	**67% in asymptomatic patients		**67% in asymptomatic patients
	**Greater than 85% in symptomatic patients		**Greater than 85% in symptomatic patients
	*~~Early~~ detection and treatment with core decompression has shown to prevent the need for total hip replacement ~~in 25% to 85% of cases studied by the American Academy of Orthopaedic Surgeons~~		*In one study by the American Academy of Orthopaedic Surgeons, early detection and treatment with core decompression has shown to prevent the need for total hip replacement.

	==See Also==		==See Also==

Jesselee7: added ref

2016-08-02T15:45:41Z

added ref

← Older revision		Revision as of 15:45, 2 August 2016
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	<references/>		<references/>
	*Kelly JD et al. Femoral head avascular necrosis treatment & management. Aug 16, 2015. http://emedicine.medscape.com/article/86568-treatment#showall.		*Kelly JD et al. Femoral head avascular necrosis treatment & management. Aug 16, 2015. http://emedicine.medscape.com/article/86568-treatment#showall.
			*Miller MD M, Fisher MD S, Foran J. Osteonecrosis of the Hip. American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=a00216. Accessed August 2, 2016.
	*Stoica Z et al. Imaging of Avascular Necrosis of Femoral Head: Familiar Methods and Newer Trends. Curr Health Sci J. 2009 Jan-Mar; 35(1): 23–28.		*Stoica Z et al. Imaging of Avascular Necrosis of Femoral Head: Familiar Methods and Newer Trends. Curr Health Sci J. 2009 Jan-Mar; 35(1): 23–28.
	*Wainwright A. Legg-Calve-Perthes disease diagnostic tests - Epocrates online. Epocrates. https://online.epocrates.com/diseases/75134/Legg-Calve-Perthes-disease/Diagnostic-Tests. Accessed July 31, 2016.		*Wainwright A. Legg-Calve-Perthes disease diagnostic tests - Epocrates online. Epocrates. https://online.epocrates.com/diseases/75134/Legg-Calve-Perthes-disease/Diagnostic-Tests. Accessed July 31, 2016.

Jesselee7: Info from american academy of orthopaedic surgeions

2016-08-02T15:42:08Z

Info from american academy of orthopaedic surgeions

← Older revision		Revision as of 15:42, 2 August 2016
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	==Disposition==		==Disposition==
	Medical and orthopedic referrals for evaluation of comorbidities and evaluation of joint should be made in the emergency department.		Medical and orthopedic referrals for evaluation of comorbidities and evaluation of joint should be made in the emergency department.
			*Progression to subchondral collapse if untreated
			**67% in asymptomatic patients
			**Greater than 85% in symptomatic patients
			*Early detection and treatment with core decompression has shown to prevent the need for total hip replacement in 25% to 85% of cases studied by the American Academy of Orthopaedic Surgeons

	==See Also==		==See Also==

Jesselee7: moved images

2016-08-02T15:21:48Z

moved images

← Older revision		Revision as of 15:21, 2 August 2016
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	[[File:Osteonecrosis of Hip.jpg\|thumb\|Kupe MD. Hip Fracture. http://drkupe.blogspot.com/2011/03/hip-fracture.html. Accessed July 31, 2016.]]		[[File:Osteonecrosis of Hip.jpg\|thumb\|Kupe MD. Hip Fracture. http://drkupe.blogspot.com/2011/03/hip-fracture.html. Accessed July 31, 2016.]]
			[[File:Osteonecrosis femur 1.jpg\|thumb\|Plain XR Osteonecrosis Femur by JMarchn(own work)]]
			[[File:Osteonecrosis MRI femur 2img.jpg\|thumb\|MRI Osteonecrosis Femur by JMarchn (ownwork)]]

	===Epidemiology===		===Epidemiology===

Jesselee7: minor edit to move images

2016-08-02T15:20:10Z

minor edit to move images

← Older revision		Revision as of 15:20, 2 August 2016
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	*Plain XR is poorly sensitive in early stages, as low as 41%		*Plain XR is poorly sensitive in early stages, as low as 41%
	**AP and Frog leg views		**AP and Frog leg views
	~~[[File:Osteonecrosis femur 1.jpg\|thumb\|Plain XR Osteonecrosis Femur by JMarchn(own work)]]~~

	*MRI ~90% sensitivity and specificity		*MRI ~90% sensitivity and specificity
	**Best test		**Best test
	~~[[File:Osteonecrosis MRI femur 2img.jpg\|thumb\|MRI Osteonecrosis Femur by JMarchn (ownwork)]]~~

	*Bone Scan (aka Bone Scintigraph)		*Bone Scan (aka Bone Scintigraph)
	**May show evidence of early bone ischemia		**May show evidence of early bone ischemia